Individual
LAURA HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1622 TIMBERWOOD BLVD STE 211, CHARLOTTESVILLE, VA 22911
(434) 202-2830
(434) 529-8457
Mailing address
1377 MOTOR PKWY STE 307, ISLANDIA, NY 11749-5258
(631) 580-5200
(631) 580-5222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
020678
NY
225100000X
Physical Therapist
Primary
2305202546
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00363213
—
NY
01
—
020678
LICENSE
NY
01
—
141731786
HOSPITAL TAX ID #
NY
Enumeration date
06/05/2007
Last updated
09/19/2019
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