Provider Demographics
NPI:1508239690
Name:HOLLAR, RICHARD BEAM III (MS, LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:BEAM
Last Name:HOLLAR
Suffix:III
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4931 SMYRNA RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-9660
Mailing Address - Country:US
Mailing Address - Phone:205-565-9998
Mailing Address - Fax:765-939-4200
Practice Address - Street 1:1400 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-8809
Practice Address - Country:US
Practice Address - Phone:765-973-8057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer