Provider Demographics
NPI:1669613584
Name:HOLLINGER, BRYCE ELLEN (DPT)
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:ELLEN
Last Name:HOLLINGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRYCE
Other - Middle Name:ELLEN
Other - Last Name:MECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3 JENNIFER CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7693
Mailing Address - Country:US
Mailing Address - Phone:717-243-0271
Mailing Address - Fax:717-243-0531
Practice Address - Street 1:3 JENNIFER CT
Practice Address - Street 2:SUITE A
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-7693
Practice Address - Country:US
Practice Address - Phone:717-243-0271
Practice Address - Fax:717-243-0531
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA148896R9XMedicare Oscar/Certification