Healthcare Provider Details

I. General information

NPI: 1073826889
Provider Name (Legal Business Name): HOWELL SCOTT HOLMES JR. PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2010
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 KEFAUVER DR STE B
MILAN TN
38358
US

IV. Provider business mailing address

2047 KEFAUVER DR STE B
MILAN TN
38358-3458
US

V. Phone/Fax

Practice location:
  • Phone: 731-238-1181
  • Fax: 731-300-2350
Mailing address:
  • Phone: 731-238-1181
  • Fax: 731-300-2350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8710
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT28671
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: