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Individual

JILLIAN KATE HOLSONBACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
304 EMORY ST, VALDOSTA, GA 31602
(229) 244-1667
(229) 244-8253
Mailing address
304 EMORY ST, VALDOSTA, GA 31602-1808
(229) 244-1667
(229) 244-8253

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
15271
NC
225100000X
Physical Therapist
Primary
PT013371
GA

Other

Enumeration date
07/11/2010
Last updated
08/20/2018
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