Healthcare Provider Details

I. General information

NPI: 1538549738
Provider Name (Legal Business Name): JOSHUA HAMILTON HOLSKEY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PATEWOOD DR STE C150
GREENVILLE SC
29615-3593
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 864-454-0904
  • Fax:
Mailing address:
  • Phone: 630-296-2223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7789
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: