Basic Information
| Provider Information | |||||||||
| NPI: | 1962536938 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HOLIHAN | ||||||||
| FirstName: | LYNN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8933 BRACKEN CLIFF CT | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891293649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022437734 | ||||||||
| FaxNumber: | 7022437734 | ||||||||
| Practice Location | |||||||||
| Address1: | 3675 PECOS MCLEOD | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891213815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026969229 | ||||||||
| FaxNumber: | 7026961003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 225100000X | 0163 | NV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.