Provider Demographics
NPI:1558877605
Name:HOLMES PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:HOLMES PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWELL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:731-238-1181
Mailing Address - Street 1:2047 KEFAUVER DR STE B
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-3458
Mailing Address - Country:US
Mailing Address - Phone:731-238-1181
Mailing Address - Fax:731-300-2350
Practice Address - Street 1:2047 KEFAUVER DR STE B
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358
Practice Address - Country:US
Practice Address - Phone:731-238-1181
Practice Address - Fax:731-300-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy