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General NPI Number Information
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NPI Number | 1518459924
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Entity Type | Individual
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Provider Name | LEAH HOLMES PTA
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Gender | Female
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Dates
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Enumeration Date | 05/31/2018
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Last Update Date | 05/31/2018
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Provider Practice Location Address
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Address Line | 1300 MEMORIAL DR
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City | DENISON
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State | TX
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Zip | 75020-2037
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Country | US
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Telephone | 903-271-8356
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Fax |
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Provider Business Mailing Address
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Address Line | 403 PARK LAKE DR
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City | MEAD
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State | OK
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Zip | 73449-6349
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Country | US
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Telephone | 817-449-4089
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2134667
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License Number State | TX
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