Individual
HOLLY PULLIAM MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTERS
Contact information
Practice address
1802 CARMEL RD, GREENSBORO, NC 27408-3120
(336) 282-6222
Mailing address
1975 YMCA CAMP RD, KING, NC 27021-8619
(336) 985-4601
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9058
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079JT
BLUE CROSS
NC
05
—
7211246
—
NC
Enumeration date
07/14/2006
Last updated
07/08/2007
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