Provider Demographics
NPI:1235542846
Name:WARNER, HOLLY (DPT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:WARNER
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:RUTH
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MT
Mailing Address - Zip Code:59833-0065
Mailing Address - Country:US
Mailing Address - Phone:406-273-6002
Mailing Address - Fax:406-273-6011
Practice Address - Street 1:2875 TINA AVE STE 2
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1581
Practice Address - Country:US
Practice Address - Phone:406-541-8778
Practice Address - Fax:406-541-8780
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-TMP-7524225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist