Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | ||
N | 226300000X | Kinesiotherapist |
NPI | 1669711339 |
---|---|
Provider Name | Sharonlee Holloway |
First Address | Gilroy, CA 95020-5711 |
Second Address | Gilroy, CA 95020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2013 |
Last Update Date | 24/05/2018 |