Individual
BRADLEY K. HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4500 8TH DIVISION RD, COLUMBIA, SC 29207-5700
(803) 751-6789
Mailing address
704 BRIDGECREEK DR, COLUMBIA, SC 29229-8908
(803) 234-5423
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3369
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00403356E
—
GA
Enumeration date
09/20/2006
Last updated
04/28/2025
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