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General NPI Number Information
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NPI Number | 1417931320
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Entity Type | Individual
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Provider Name | SCOTT LAWRENCE HOLMAN PT DPT OCS
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Gender | Male
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 61 RIVERWALK BLVD STE 2F
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City | RIDGELAND
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State | SC
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Zip | 29936-5071
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Country | US
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Telephone | 951-375-7102
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Fax |
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Provider Business Mailing Address
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Address Line | 66 DAFFODIL FARM RD
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City | BLUFFTON
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State | SC
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Zip | 29910-5349
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Country | US
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Telephone | 951-375-7102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 3869
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3869
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License Number State | SC
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