Provider Demographics
NPI:1720312994
Name:HOLLEY, KERI LYNNE
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:LYNNE
Last Name:HOLLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ORWIGSBURG MANOR DR
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-1303
Mailing Address - Country:US
Mailing Address - Phone:570-366-2999
Mailing Address - Fax:570-366-8924
Practice Address - Street 1:1000 ORWIGSBURG MANOR DR
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-1303
Practice Address - Country:US
Practice Address - Phone:570-366-2999
Practice Address - Fax:570-366-8924
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1002101225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant