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Organization
THE HOLLOWAY REHABILITATION AND PAIN CENTER INC
Active
Organization
THE HOLLOWAY REHABILITATION AND PAIN CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VANESSA HOLLOWAY (MANAGER)
(305) 598-9696
Entity
Organization
Contact information
Practice address
12245 SW 112TH ST, MIAMI, FL 33186-4830
(305) 598-9696
(305) 598-4479
Mailing address
12245 SW 112TH ST, MIAMI, FL 33186-4830
(305) 598-9696
(305) 598-4479
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0001638
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891154100
—
FL
Enumeration date
04/22/2008
Last updated
08/09/2012
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