Individual
HOLLY SHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2314 PULASKI HWY, SUITE A, NORTH EAST, MD 21901-3730
(410) 287-2940
(410) 287-2941
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25331
MD
Other
Enumeration date
12/10/2014
Last updated
02/22/2016
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