Provider Demographics
NPI:1073826889
Name:HOLMES, HOWELL SCOTT JR (PT)
Entity Type:Individual
Prefix:DR
First Name:HOWELL
Middle Name:SCOTT
Last Name:HOLMES
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2047 KEFAUVER DR STE B
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-3458
Mailing Address - Country:US
Mailing Address - Phone:731-238-1181
Mailing Address - Fax:731-300-2350
Practice Address - Street 1:2047 KEFAUVER DR STE B
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358
Practice Address - Country:US
Practice Address - Phone:731-238-1181
Practice Address - Fax:731-300-2350
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT286712251X0800X
TN8710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHS452ZOtherMEDICARE PTAN