Provider Demographics
NPI:1528371606
Name:HOLMES, JONELLE ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:JONELLE
Middle Name:ELIZABETH
Last Name:HOLMES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 PLEASANT VIEW RD
Mailing Address - Street 2:
Mailing Address - City:NEW COLUMBIA
Mailing Address - State:PA
Mailing Address - Zip Code:17856-9114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 E 8TH ST
Practice Address - Street 2:
Practice Address - City:WATSONTOWN
Practice Address - State:PA
Practice Address - Zip Code:17777-1033
Practice Address - Country:US
Practice Address - Phone:570-538-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020621225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist