Provider Demographics
NPI:1831250232
Name:HOLLINGSHEAD, GARLYN ELIZABETH (MPT)
Entity type:Individual
Prefix:
First Name:GARLYN
Middle Name:ELIZABETH
Last Name:HOLLINGSHEAD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 N FOWLER AVE
Mailing Address - Street 2:APT. #103
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6610
Mailing Address - Country:US
Mailing Address - Phone:559-324-0813
Mailing Address - Fax:
Practice Address - Street 1:2181 HERNDON AVE STE 102
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6309
Practice Address - Country:US
Practice Address - Phone:559-573-3430
Practice Address - Fax:559-573-3432
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33332225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist