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Individual

MRS. MARY L HOLLINGSWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
745 S PEAR ORCHARD RD, RIDGELAND, MS 39157-5128
(601) 260-4605
Mailing address
745 S PEAR ORCHARD RD, RIDGELAND, MS 39157-5128
(601) 260-4605

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3411
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00124646
MS
01
PT3411
MS LICENSE
MS
Enumeration date
05/18/2007
Last updated
10/17/2013
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