Provider Demographics
NPI:1841680972
Name:STEVENS, HOLLI JOY (PT,, DPT)
Entity type:Individual
Prefix:DR
First Name:HOLLI
Middle Name:JOY
Last Name:STEVENS
Suffix:
Gender:F
Credentials:PT,, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:GA
Mailing Address - Zip Code:31545-1435
Mailing Address - Country:US
Mailing Address - Phone:912-256-5610
Mailing Address - Fax:912-559-6346
Practice Address - Street 1:430 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:GA
Practice Address - Zip Code:31545-1435
Practice Address - Country:US
Practice Address - Phone:912-256-5610
Practice Address - Fax:912-559-6346
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist