Healthcare Provider Details

I. General information

NPI: 1538684618
Provider Name (Legal Business Name): THOMAS HOLCOMBE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

696 W LINCOLN HWY
EXTON PA
19341-2514
US

IV. Provider business mailing address

1695 S STATE ST # A
DOVER DE
19901-5148
US

V. Phone/Fax

Practice location:
  • Phone: 302-552-1120
  • Fax: 302-552-1121
Mailing address:
  • Phone: 302-552-1120
  • Fax: 302-552-1121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0003757
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT034146
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: