Healthcare Provider Details

I. General information

NPI: 1760214944
Provider Name (Legal Business Name): JADA HOLMES PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 MARK DABLING BLVD
COLORADO SPRINGS CO
80918-3839
US

IV. Provider business mailing address

3617 CARSON CIR
MCKINNEY TX
75070-0210
US

V. Phone/Fax

Practice location:
  • Phone: 719-592-1584
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1397080
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: