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General NPI Number Information
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NPI Number | 1881187177
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Entity Type | Individual
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Provider Name | DR. MICHAEL E HOLMES
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Gender | Male
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 1533 OAKDALE RD
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City | MODESTO
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State | CA
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Zip | 95355-3305
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Country | US
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Telephone | 209-554-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 ASPIRE WAY
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City | MODESTO
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State | CA
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Zip | 95356-8007
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Country | US
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Telephone | 614-546-5728
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT017464
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License Number State | OH
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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 | 27559
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 298383
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License Number State | CA
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