Individual
JENNIFER MICHELLE HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010565
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11760444
CAQH
MI
01
—
650H222720
BCBS
MI
01
—
650H228680
BCBS
MI
01
—
P00132801
RAILROAD
MI
01
—
P00363453
RAILROAD
MI
Enumeration date
07/26/2006
Last updated
04/24/2008
Update your record
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