Provider Demographics
NPI:1255589529
Name:HOLMES, KEIRON A (DPT, PT)
Entity type:Individual
Prefix:MR
First Name:KEIRON
Middle Name:A
Last Name:HOLMES
Suffix:
Gender:
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2189 ELROD AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:QUANTICO
Mailing Address - State:VA
Mailing Address - Zip Code:22134-5113
Mailing Address - Country:US
Mailing Address - Phone:703-784-3205
Mailing Address - Fax:
Practice Address - Street 1:2189 ELROD AVE
Practice Address - Street 2:
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22134-5113
Practice Address - Country:US
Practice Address - Phone:703-784-3205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052053792251X0800X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic