Individual
HOLLY NEISWENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2215 E HENRY AVE, TAMPA, FL 33610-4432
(813) 239-1179
(813) 237-3091
Mailing address
2215 E HENRY AVE, TAMPA, FL 33610-4432
(813) 239-1179
(813) 237-3091
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
PT0002911
FL
225100000X
Physical Therapist
PTOOO2911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000122200
—
FL
05
—
880492301
—
FL
Enumeration date
06/22/2006
Last updated
02/15/2011
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