Provider Demographics
NPI:1093579369
Name:HOLLAND, JANIS (RT(R))
Entity type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 CAMERON ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-1806
Mailing Address - Country:US
Mailing Address - Phone:434-594-0174
Mailing Address - Fax:
Practice Address - Street 1:720 CAMERON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1806
Practice Address - Country:US
Practice Address - Phone:434-594-0174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225500000X
VA0120010537247100000X, 2471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist