Provider Demographics
NPI:1215640057
Name:WEBB, HOLLEY
Entity type:Individual
Prefix:
First Name:HOLLEY
Middle Name:
Last Name:WEBB
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 1:8784 CHRISTIE DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-6405
Mailing Address - Country:US
Mailing Address - Phone:740-497-3686
Mailing Address - Fax:
Practice Address - Street 1:1944 N HERCULES AVE STE C
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-4403
Practice Address - Country:US
Practice Address - Phone:727-797-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist