Provider Demographics
NPI:1568425981
Name:HOLTBY, ROBERT E (MA PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:HOLTBY
Suffix:
Gender:M
Credentials:MA PT
Other - Prefix:
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Mailing Address - Street 1:1825 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-7871
Mailing Address - Country:US
Mailing Address - Phone:719-599-8550
Mailing Address - Fax:719-218-9200
Practice Address - Street 1:1825 AUSTIN BLUFFS PKWY
Practice Address - Street 2:100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-7871
Practice Address - Country:US
Practice Address - Phone:719-599-8550
Practice Address - Fax:719-218-9200
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
469138Medicare ID - Type Unspecified
P61642Medicare UPIN