MRS. Holly Renee Shoesmith, PTA

NPI #1033533880 in Carlyle, Illinois

Provider Information

NPI Number: 1033533880
Entity Type: Individual
Name: MRS. Holly Renee Shoesmith, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: PTA
Enumeration Date: Feb 14, 2014
Last Updated: Feb 14, 2014

Practice Location

Address: 13829 VINCENNES DR
City: Carlyle
State: Illinois
ZIP Code: 62231-2539
Phone: (618) 594-8067

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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