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Individual

HOLLY LICKWALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1118 VIEW AVE, CENTRALIA, WA 98531-1870
(360) 736-8273
(360) 736-5053
Mailing address
1118 VIEW AVE, CENTRALIA, WA 98531-1870
(360) 736-8273
(360) 736-5053

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
6214
AZ
225100000X
Physical Therapist
Primary
PT60272758
WA

Other

Enumeration date
01/19/2009
Last updated
08/21/2020
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