Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1896 | TN |
N | 2251X0800X | Physical Therapist - Orthopedic | PT0000001896 | TN |
NPI | 1003252891 |
---|---|
Provider Name | John Paul Holden JR. |
First Address | Franklin, TN 37068-1478 |
Second Address | Murfreesboro, TN 37130-6059 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 26/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0446631 | (05) | TN |