Individual
MRS. KIMBERLY V. HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
102 EASTBROOK DR, SUITE C, GREENVILLE, NC 27858-4211
(252) 830-0245
(252) 830-0247
Mailing address
PO BOX 2163, GREENVILLE, NC 27836-0163
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5864
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1402G
BLUECROSS BLUESHIELD
NC
01
—
183902
MEDCOST PROVIDER NUMBER
NC
Enumeration date
08/22/2006
Last updated
07/08/2007
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