Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 057085 | GA |
NPI | 1326131467 |
---|---|
Provider Name | Dr. Thomas M. Holmes |
First Address | Marietta, GA 30060-7241 |
Second Address | Marietta, GA 30060-7241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 31/03/2011 |