Provider Demographics
NPI:1740565001
Name:HOLMAN, MARGERY CLAIRE (DPT)
Entity Type:Individual
Prefix:DR
First Name:MARGERY
Middle Name:CLAIRE
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 THIRD STREET,
Mailing Address - Street 2:STE 2
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850
Mailing Address - Country:US
Mailing Address - Phone:607-272-9937
Mailing Address - Fax:607-272-9996
Practice Address - Street 1:402 THIRD STREET,
Practice Address - Street 2:STE 2
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-272-9937
Practice Address - Fax:607-272-9996
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034291-1208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation