Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | 1338031 | TX |
N | 213ES0000X | Sports Medicine | 1338031 | TX |
Y | 225100000X | Physical Therapist | PT4884 | AR |
NPI | 1255945473 |
---|---|
Provider Name | Brooke Ann Hollingsworth |
First Address | Bentonville, AR 72712-7017 |
Second Address | Bentonville, AR 72712-7017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2020 |
Last Update Date | 15/04/2021 |