Individual
HOLLY MAE HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(785) 806-5556
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36004121A
IN
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/19/2019
Last updated
07/28/2026
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