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Mrs. Holly Renee Shoesmith, PTA
Specialist in Carlyle, Illinois
NPI 1033533880

Holly Renee Shoesmith is a Specialist based in Carlyle, IL. Holly Renee Shoesmith practices in Carlyle, IL and has the professional credentials of PTA. The NPI Number for Holly Renee Shoesmith is 1033533880 and holds a License No. 160.005504 (Illinois).

The current practice location address for Holly Renee Shoesmith is 13829 Vincennes Dr, Carlyle, IL and can be reached out via phone at 618-594-8067.

Location: 13829 Vincennes Dr, Carlyle, IL, 62231-2539
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033533880
Provider Name
Holly Renee Shoesmith
Credential
PTA
Provider Entity Type
Individual
Gender
Female
Address
13829 Vincennes Dr, Carlyle, IL, 62231-2539
Phone Number
618-594-8067
Fax Number
Provider Enumeration Date
02/14/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
13829 Vincennes Dr
City
Carlyle
State
Illinois
Zip
62231-2539
Phone Number
618-594-8067
Fax Number
person
Provider Business Mailing Address Details
Address
13829 Vincennes Dr
City
Carlyle
State
Illinois
Zip
62231-2539
Phone Number
618-594-8067
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
160.005504 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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