Provider Demographics
NPI:1427523398
Name:HOLLAND, KRYSTYNA ADAIR (PT)
Entity type:Individual
Prefix:
First Name:KRYSTYNA
Middle Name:ADAIR
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1699 N DOWNING ST APT 102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1564
Mailing Address - Country:US
Mailing Address - Phone:571-283-3552
Mailing Address - Fax:
Practice Address - Street 1:121 S MADISON ST STE D
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3019
Practice Address - Country:US
Practice Address - Phone:571-283-3552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00157522081N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine