Provider Demographics
NPI:1346082427
Name:HOLLOWAY, BRIEANN P (DPT)
Entity type:Individual
Prefix:DR
First Name:BRIEANN
Middle Name:P
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 757
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89024
Mailing Address - Country:US
Mailing Address - Phone:702-346-1899
Mailing Address - Fax:702-346-8581
Practice Address - Street 1:1140 W PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027
Practice Address - Country:US
Practice Address - Phone:702-346-1899
Practice Address - Fax:702-346-8581
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13989448-8016225100000X
NV6635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist