Provider Demographics
NPI:1588653034
Name:HOLMES, KAREN (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:191 ELM ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-1814
Mailing Address - Country:US
Mailing Address - Phone:978-499-1870
Mailing Address - Fax:978-499-1871
Practice Address - Street 1:37 1/2 FORRESTER ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-1938
Practice Address - Country:US
Practice Address - Phone:978-465-2862
Practice Address - Fax:978-465-2839
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68211Medicare ID - Type Unspecified