Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 1468 | TX |
NPI | 1225463896 |
---|---|
Provider Name | Julie D Hollimon |
First Address | Plano, TX 75024-3254 |
Second Address | Plano, TX 75024-3254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2013 |
Last Update Date | 23/09/2013 |