Individual
MS. JENETTE K HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
928 DIAMOND SPRINGS RD STE 103, VIRGINIA BEACH, VA 23455-6601
(757) 395-1975
(757) 425-7180
Mailing address
928 DIAMOND SPRINGS RD STE 103, VIRGINIA BEACH, VA 23455-6601
(757) 395-1975
(757) 425-7180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305204366
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184149
ANTHEM-BCBS
VA
01
—
C05954
GROUP MEDICARE PTAN
VA
Enumeration date
11/30/2005
Last updated
04/22/2022
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