Provider Demographics
NPI:1942346184
Name:HOLMES, KAREN (LMT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SEMINOLE WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1346
Mailing Address - Country:US
Mailing Address - Phone:585-271-7690
Mailing Address - Fax:
Practice Address - Street 1:693 EAST AVE
Practice Address - Street 2:RETREAT HOUSE MASSAGE 2ND FLOOR
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2152
Practice Address - Country:US
Practice Address - Phone:585-271-7690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016748225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist