Healthcare Provider Details

I. General information

NPI: 1831124700
Provider Name (Legal Business Name): CELYN P HOLT PT, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2718 HENRY ST
GREENSBORO NC
27405-3633
US

IV. Provider business mailing address

2718 HENRY ST
GREENSBORO NC
27405-3633
US

V. Phone/Fax

Practice location:
  • Phone: 336-375-1007
  • Fax: 336-375-9615
Mailing address:
  • Phone: 336-375-1007
  • Fax: 336-375-9615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP1869
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: