Provider Demographics
NPI:1124420898
Name:LINDHOLM, A. HELENA (PT)
Entity type:Individual
Prefix:
First Name:A.
Middle Name:HELENA
Last Name:LINDHOLM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:A.
Other - Middle Name:HELENA
Other - Last Name:LINDHOLM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:3040 BERKMAR DR STE A1
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1593
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3040 BERKMAR DR STE A1
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1593
Practice Address - Country:US
Practice Address - Phone:434-249-9578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305000893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist