Basic Information
| Provider Information | |||||||||
| NPI: | 1396089447 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEART | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BOOTH | ||||||||
| OtherFirstName: | HOLLY | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 20410 CENTURY BLVD | ||||||||
| Address2: | NRH REHAB NETWORK - SUITE 215 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208741186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015406140 | ||||||||
| FaxNumber: | 3015405190 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 IRVING ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200102921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015406140 | ||||||||
| FaxNumber: | 3015405190 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2012 | ||||||||
| LastUpdateDate: | 11/15/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | A3099 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.