Basic Information
| Provider Information | |||||||||
| NPI: | 1619464591 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLMES | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | CAROL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 618 SHELLEY CT | ||||||||
| Address2: | |||||||||
| City: | LITITZ | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175439312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015247116 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2108 HARRISBURG PIKE STE 30153 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175443555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2018 | ||||||||
| LastUpdateDate: | 04/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MSG008174 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.