Basic Information
Provider Information
NPI: 1285657346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLMAN
FirstName: KAREN
MiddleName: ANNE
NamePrefix: MRS.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 853 SHAUMONT DR
Address2:  
City: WEST CHESTER
State: PA
PostalCode: 193825545
CountryCode: US
TelephoneNumber: 6102098915
FaxNumber:  
Practice Location
Address1: 1161 MCDERMOTT DR
Address2:  
City: WEST CHESTER
State: PA
PostalCode: 193804064
CountryCode: US
TelephoneNumber: 4843569401
FaxNumber: 4843569405
Other Information
ProviderEnumerationDate: 07/26/2006
LastUpdateDate: 08/13/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT 015830PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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