Provider Demographics
NPI:1578816179
Name:HOLSMAN PHYSICAL THERAPY AND WELLNESS PC
Entity Type:Organization
Organization Name:HOLSMAN PHYSICAL THERAPY AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MAT, GCS
Authorized Official - Phone:973-393-5545
Mailing Address - Street 1:710 MILL ST
Mailing Address - Street 2:UNIT H3
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-5318
Mailing Address - Country:US
Mailing Address - Phone:973-393-5545
Mailing Address - Fax:973-759-0557
Practice Address - Street 1:408 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1813
Practice Address - Country:US
Practice Address - Phone:973-433-0732
Practice Address - Fax:973-883-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2013-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009789002251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty