Individual
HOLLY BRODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
620 S VANCE ST, #1302, LAKEWOOD, CO 80226-5018
(214) 902-5792
Mailing address
620 S VANCE ST, #1302, LAKEWOOD, CO 80226-5018
(214) 902-5792
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013065
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013065
MEDICARE
CO
Enumeration date
02/14/2013
Last updated
02/14/2013
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