Individual
JACOB HOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
117 ORVILLE RD, BALTIMORE, MD 21221-1309
(410) 686-2270
(410) 686-5447
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25367
MD
Other
Enumeration date
01/16/2015
Last updated
04/14/2015
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