Provider Demographics
NPI:1215346267
Name:HOLLINGSHEAD, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HOLLINGSHEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11469 PICKLE RD
Mailing Address - Street 2:
Mailing Address - City:BROGUE
Mailing Address - State:PA
Mailing Address - Zip Code:17309-9004
Mailing Address - Country:US
Mailing Address - Phone:717-927-6778
Mailing Address - Fax:
Practice Address - Street 1:601 GORAM RD
Practice Address - Street 2:
Practice Address - City:BROGUE
Practice Address - State:PA
Practice Address - Zip Code:17309-9327
Practice Address - Country:US
Practice Address - Phone:717-927-6778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-04
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4105225200000X
PATE1004936225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant