Provider Demographics
NPI:1912587130
Name:KNOWLES, HOLLE (LMT)
Entity Type:Individual
Prefix:
First Name:HOLLE
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4331 LAMBERT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-4714
Mailing Address - Country:US
Mailing Address - Phone:843-513-7874
Mailing Address - Fax:
Practice Address - Street 1:4331 LAMBERT ST
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-4714
Practice Address - Country:US
Practice Address - Phone:843-513-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12316225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist