Individual
HOLLY RENEE MCCOLLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2981 SW 22ND ST, FORT LAUDERDALE, FL 33312-4356
(954) 328-6195
(954) 783-8161
Mailing address
2981 SW 22ND ST, FORT LAUDERDALE, FL 33312-4356
(954) 328-6195
(954) 783-8161
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
24939
FL
2251P0200X
Pediatric Physical Therapist
Primary
24939
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001377000
—
FL
Enumeration date
08/24/2009
Last updated
10/01/2013
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