Individual
MYRA HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
65 ALBANY TPKE, SUITE A, CANTON, CT 06019-2507
(860) 693-6226
(860) 693-8002
Mailing address
PO BOX 466, CANTON, CT 06019-0466
(860) 693-6226
(860) 693-8002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004944
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C03076
CANTON PHYSICAL THERAPY PTAN
CT
Enumeration date
02/10/2016
Last updated
02/10/2016
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