Most Relevant Information
Provider Data
| NPI Number: | 1003291808 |
| Provider Name: | JESSE HOLLIDAY P.T.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/22/2015 |
| Last Updated: | 07/22/2015 |
Provider Practice Location
8200 GOOD LUCK RD
LANHAM
MD
207063511
Practice Location Phone/Fax
| Phone: | 3015522000 |
| Fax: |
Provider Mailing Location
5121 LACKAWANNA ST
COLLEGE PARK
MD
207404530
Provider Mailing Phone/Fax
| Phone: | 8646071615 |
| Fax: |