Individual
CHARLES E HOLLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
161 BERRYHILL CV, PONTOTOC, MS 38863-7698
(662) 308-8484
Mailing address
161 BERRYHILL CV, PONTOTOC, MS 38863-7698
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3963
MS
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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