Individual
HOLLY DEANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
17603 MISSION RDG, SMITHVILLE, MO 64089-8005
(636) 541-0980
Mailing address
17603 MISSION RDG, SMITHVILLE, MO 64089-8005
(636) 541-0980
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2021028506
MO
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
08/03/2021
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