Provider Demographics
NPI:1528348984
Name:HOLDER, HAILEY MARIE (DPT)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:MARIE
Last Name:HOLDER
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 1:198 HILLVIEW ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1285
Mailing Address - Country:US
Mailing Address - Phone:615-446-8159
Mailing Address - Fax:615-446-8162
Practice Address - Street 1:198 HILLVIEW ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1285
Practice Address - Country:US
Practice Address - Phone:615-446-8159
Practice Address - Fax:615-446-8162
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist