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NPI Code Detail

MEDICARE: HOLSMAN PHYSICAL THERAPY AND WELLNESS PC

MEDICARE: HOLSMAN PHYSICAL THERAPY AND WELLNESS PC
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
12251G0304XGeriatric Physical Therapist40QA00978900NJ

General Provider Information

NPI Number : 1578816179
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOLSMAN PHYSICAL THERAPY AND WELLNESS PC
Provider Business Mailing Address
First Line : 710 MILL ST
Second Line : UNIT H3
City : BELLEVILLE
State : NJ
Zip : 07109-5318
Country : US
Telephone Number : 973-393-5545
Fax Number : 973-759-0557
Provider Business Practice Location Address
First Line : 408 POMPTON AVE
Second Line :
City : CEDAR GROVE
State : NJ
Zip : 07009-1813
Country : US
Telephone Number : 973-433-0732
Fax Number : 973-883-0140
Authorized Official
Title or Position : PRESIDENT
Name : RICHARD HOLSMAN
Credential : PT, MAT, GCS
Telephone Number : 973-393-5545
Provider Enumeration Date : 10/19/2012
Last Update Date : 01/01/2013

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