Provider Demographics
NPI:1437805504
Name:HOLTS HEALTHCARE PAIN & WELLNESS PC
Entity Type:Organization
Organization Name:HOLTS HEALTHCARE PAIN & WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KALATO
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLTS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:470-402-9409
Mailing Address - Street 1:165 BRADFORD SQ STE A
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-1960
Mailing Address - Country:US
Mailing Address - Phone:470-402-9409
Mailing Address - Fax:470-558-2898
Practice Address - Street 1:165 BRADFORD SQ STE A
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-1960
Practice Address - Country:US
Practice Address - Phone:470-402-9409
Practice Address - Fax:470-558-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-26
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty