Individual
ANDREA LYN HOLRATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4317 PARK PL, TYLER, TX 75703-1883
(903) 649-3433
Mailing address
4317 PARK PL, TYLER, TX 75703-1883
(903) 649-3433
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2063450
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2063450
PTA LICENSE #
TX
Enumeration date
09/13/2007
Last updated
09/13/2007
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