Provider Demographics
NPI:1528476645
Name:HOLT, TIMOTHY E (PT, DPT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:E
Last Name:HOLT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WINDWARD DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2174
Mailing Address - Country:US
Mailing Address - Phone:540-949-5383
Mailing Address - Fax:540-949-5493
Practice Address - Street 1:32 WINDWARD DR
Practice Address - Street 2:SUITE 110
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2174
Practice Address - Country:US
Practice Address - Phone:540-949-5383
Practice Address - Fax:540-949-5493
Is Sole Proprietor?:No
Enumeration Date:2014-08-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist