Individual
MR. RUSSELL DAVID HOLCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPO
Contact information
Practice address
95 HICKORY SPRINGS IND DR, CANTON, GA 30115-7933
(770) 345-6899
(770) 345-7341
Mailing address
95 HICKORY SPRINGS INDUSTRIAL DR, CANTON, GA 30115-7933
(770) 345-6899
(770) 345-7341
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
003
GA
224P00000X
Prosthetist
Primary
003
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7700620
—
NC
Enumeration date
01/02/2007
Last updated
09/11/2025
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