Provider Demographics
NPI:1548463904
Name:YORK, HOLLY R (LMT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:R
Last Name:YORK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 UTICA ST
Mailing Address - Street 2:OFFICE AT PRECISION CUTS AND COLORS
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-1108
Mailing Address - Country:US
Mailing Address - Phone:315-824-3384
Mailing Address - Fax:
Practice Address - Street 1:1947 QUARTERLINE RD
Practice Address - Street 2:
Practice Address - City:HUBBARDSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13355-1157
Practice Address - Country:US
Practice Address - Phone:315-790-8631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013871225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist