Healthcare Provider Details

I. General information

NPI: 1699333914
Provider Name (Legal Business Name): ABIGAIL K HOLMES DPT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2019
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CHARLES PL
MANHATTAN KS
66502-2750
US

IV. Provider business mailing address

1600 CHARLES PL
MANHATTAN KS
66502-2750
US

V. Phone/Fax

Practice location:
  • Phone: 785-537-4200
  • Fax: 844-749-1114
Mailing address:
  • Phone: 785-537-4200
  • Fax: 844-749-1114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number11-06120
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: