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Individual

HOLLY FUNDENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
4820 NEWBERRY RD, GAINESVILLE, FL 32607-2249
(352) 373-2116
Mailing address
14305 NW 186TH AVE, ALACHUA, FL 32615-4204
(351) 871-4857

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA30079
FL

Other

Enumeration date
03/18/2020
Last updated
03/18/2020
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