Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 8710 | TN |
N | 2251X0800X | Physical Therapist - Orthopedic | PT28671 | FL |
NPI | 1073826889 |
---|---|
Provider Name | Dr. Howell Scott Holmes JR. |
First Address | Milan, TN 38358-3458 |
Second Address | Milan, TN 38358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2010 |
Last Update Date | 16/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
HS452Z | MEDICARE PTAN (01) | FL |