Holly Lane Knowles, PTA

Key facts

NPI

1497090401

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

License

PTA 22614 (FL)

Practice address

371 Coral Ave
Ramrod Key, FL 33042-5323

Phone

(850) 419-4191

NPI assigned

Dec 2, 2012

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 2, 2012.

{
    "created_epoch": "1354406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354406400000",
    "number": "1497090401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 CORAL AVE",
            "city": "RAMROD KEY",
            "state": "FL",
            "postal_code": "330425323",
            "telephone_number": "850-419-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 CORAL AVE",
            "city": "RAMROD KEY",
            "state": "FL",
            "postal_code": "330425323",
            "telephone_number": "850-419-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "HOLLY",
        "middle_name": "LANE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-02",
        "last_updated": "2012-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 22614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ramrod Key, FL

• Adm Behavioral Solutions LLC
• Kimberly Altman, DIETITIAN
• Joyce Elsie Defrancesco, APRN, FNP-BC
• Diane Lundy, MD
• Tatyana Mironova
• Mosaic Wellness. Inc.
• Brian Quesenberry, LMT
• Jane Ann Tiedeman, O.T.

All providers in Ramrod Key, FL · Physical Therapy Assistant in Florida