Individual
MILLICENT E. HOLLIMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
15190 COMMUNITY RD, SUITE 120, GULFPORT, MS 39503-3485
(228) 831-0416
(228) 831-0521
Mailing address
PO BOX 8419, BILOXI, MS 39535-8087
(228) 388-5714
(228) 388-0017
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4480
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015077
—
MS
01
—
1033218524
GROUP NPI
MS
Enumeration date
08/05/2010
Last updated
06/28/2012
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