Individual
STEPHANIE LYNN HOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
619 EDGAR AVE, RONCEVERTE, WV 24970-1258
(304) 952-3093
Mailing address
1015 LEWIS RD, RONCEVERTE, WV 24970-8317
(304) 952-3093
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2015-3362
WV
Other
Enumeration date
12/29/2017
Last updated
12/29/2017
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