Provider Demographics
NPI:1164575718
Name:HOLMES, DEBORAH MARIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:MARIE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6309 BALTIMORE AVE
Mailing Address - Street 2:301
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1059
Mailing Address - Country:US
Mailing Address - Phone:301-699-1580
Mailing Address - Fax:301-699-1583
Practice Address - Street 1:6309 BALTIMORE AVE
Practice Address - Street 2:301
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20374
Practice Address - Country:US
Practice Address - Phone:301-699-1580
Practice Address - Fax:301-699-1583
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT471225100000X
MD14782225100000X
NY022465-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist