Healthcare Provider Details

I. General information

NPI: 1891013975
Provider Name (Legal Business Name): AARON HOLMES LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 05/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 MAIN ST STE 2
RICHMOND ME
04357-3722
US

IV. Provider business mailing address

728 MAIN ST. STE 2
RICHMOND ME
04357
US

V. Phone/Fax

Practice location:
  • Phone: 207-737-7000
  • Fax:
Mailing address:
  • Phone: 207-737-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT1631
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: