Provider Demographics
NPI:1215185111
Name:HOLBROOK, NATHAN C (PT)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:C
Last Name:HOLBROOK
Suffix:
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 1:24400 HIGHPOINT RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6054
Mailing Address - Country:US
Mailing Address - Phone:216-896-0824
Mailing Address - Fax:216-896-0825
Practice Address - Street 1:24400 HIGHPOINT RD
Practice Address - Street 2:SUITE 10
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6054
Practice Address - Country:US
Practice Address - Phone:216-896-0824
Practice Address - Fax:216-896-0825
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist