Provider Demographics
NPI:1215148481
Name:FREUDENBERG, HOLLY ANN (BS, PT, DPT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:FREUDENBERG
Suffix:
Gender:F
Credentials:BS, PT, DPT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:ANN
Other - Last Name:BOEHNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4135 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-3721
Mailing Address - Country:US
Mailing Address - Phone:605-221-6114
Mailing Address - Fax:
Practice Address - Street 1:1101 26TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5161
Practice Address - Country:US
Practice Address - Phone:406-455-5238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2038PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist