Individual
KATIE HOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20072 SW BIRCH ST STE 190, NEWPORT BEACH, CA 92660-0799
(949) 673-8088
Mailing address
851 DOMINGO DR APT 24, NEWPORT BEACH, CA 92660-4578
(949) 274-0248
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
18516
CA
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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