Healthcare Provider Details

I. General information

NPI: 1932504404
Provider Name (Legal Business Name): HOLSMAN WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 10/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SAINT GEORGES AVE SUITE 118
RAHWAY NJ
07065-2764
US

IV. Provider business mailing address

710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5318
US

V. Phone/Fax

Practice location:
  • Phone: 732-428-5566
  • Fax: 732-428-5513
Mailing address:
  • Phone: 973-759-1494
  • Fax: 973-759-0557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00978900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00413400
License Number StateNJ

VIII. Authorized Official

Name: DR. RICHARD S HOLSMAN
Title or Position: PRESIDENT
Credential: DPT
Phone: 973-393-5545