Provider Demographics
NPI:1306591359
Name:HOLTZ, ISAAC (DPT)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:HOLTZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9139 RENNER BLVD APT 920
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1773
Mailing Address - Country:US
Mailing Address - Phone:319-480-9007
Mailing Address - Fax:
Practice Address - Street 1:2113 E KANSAS CITY RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7050
Practice Address - Country:US
Practice Address - Phone:913-791-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist