Individual
HOLLY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2268 ROSS RD, OLIVE BRANCH, MS 38654-9406
(662) 808-2680
(662) 895-0566
Mailing address
2268 ROSS RD, OLIVE BRANCH, MS 38654-9406
(662) 808-2680
(662) 895-0566
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2762
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9189701
—
MS
Enumeration date
10/25/2010
Last updated
07/12/2023
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