MEDICARE: HOLT PELVIC HEALTH & WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1447194071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLT PELVIC HEALTH & WELLNESS

Provider Business Mailing Address
First Line	:	9705 TEHAMA RIDGE PKWY STE 122
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-7522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9705 TEHAMA RIDGE PKWY STE 122
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-7522
Country	:	US
Telephone Number	:	920-471-3700
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/OWNER
Name	:	JENNIFER HOLT
Credential	:	DPT
Telephone Number	:	920-471-3700

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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