Provider Demographics
NPI:1881368587
Name:HOLT, XARLES XAVIER (PT, DPT, SCS)
Entity type:Individual
Prefix:DR
First Name:XARLES
Middle Name:XAVIER
Last Name:HOLT
Suffix:
Gender:M
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 N CAMINO SECO APT 281
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2972
Mailing Address - Country:US
Mailing Address - Phone:217-251-7645
Mailing Address - Fax:
Practice Address - Street 1:1040 S HARRISON RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-6601
Practice Address - Country:US
Practice Address - Phone:520-485-5454
Practice Address - Fax:520-325-4002
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31915225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist