Provider Demographics
NPI:1245244284
Name:HOLMES, HEATHER LYNN (MPT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNN
Other - Last Name:BURT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:300 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2638
Mailing Address - Country:US
Mailing Address - Phone:303-781-2181
Mailing Address - Fax:866-385-2921
Practice Address - Street 1:300 E HAMPDEN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2638
Practice Address - Country:US
Practice Address - Phone:303-781-2181
Practice Address - Fax:866-385-2921
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT10472225100000X
CO9802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2442806Medicaid
OH4113441Medicare ID - Type Unspecified