Provider Demographics
NPI:1982794202
Name:HOLLYFIELD, LYNN D (MSPT)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:D
Last Name:HOLLYFIELD
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 BRYAN POINT RD
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-2348
Mailing Address - Country:US
Mailing Address - Phone:301-292-4074
Mailing Address - Fax:
Practice Address - Street 1:821 BRYAN POINT RD
Practice Address - Street 2:
Practice Address - City:ACCOKEEK
Practice Address - State:MD
Practice Address - Zip Code:20607-2348
Practice Address - Country:US
Practice Address - Phone:301-292-4074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist