Provider Demographics
NPI:1134159296
Name:HOLTSCHULTE, TROY DOUGLAS (PT)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:DOUGLAS
Last Name:HOLTSCHULTE
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 1:4191 KING GEORGE DR
Mailing Address - Street 2:APT 3
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-1415
Mailing Address - Country:US
Mailing Address - Phone:717-920-4950
Mailing Address - Fax:717-920-4955
Practice Address - Street 1:450 POWERS AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5933
Practice Address - Country:US
Practice Address - Phone:717-920-4950
Practice Address - Fax:717-920-4955
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013875L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist