Individual
KILEY ZELLITTI HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
904 S VANGUARD WAY STE 110, MERIDIAN, ID 83642-7552
(208) 803-6767
(208) 803-6766
Mailing address
645 E STATE ST STE 101, EAGLE, ID 83616-5915
(208) 939-9594
(208) 939-9828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
25568
MD
225100000X
Physical Therapist
Primary
PT-6736
ID
225100000X
Physical Therapist
PT60363672
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0312053
DEPT OF LABOR AND INDUSTRIES
WA
Enumeration date
11/29/2012
Last updated
05/21/2020
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