Provider Demographics
NPI:1639282700
Name:HOLSTEN, SCOTT E (PT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:E
Last Name:HOLSTEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 EDGEHILL RD N
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1885
Mailing Address - Country:US
Mailing Address - Phone:704-355-9473
Mailing Address - Fax:704-446-6084
Practice Address - Street 1:1010 EDGEHILL RD N
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1885
Practice Address - Country:US
Practice Address - Phone:704-355-9473
Practice Address - Fax:704-446-6084
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist