Greg S Holt, PT
Individual provider Active NPI Physical Therapist · Woodruff, WI
NPI 1104909977 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1104909977
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 3111-024 (WI)
- Practice address
- 240 Maple Street
Woodruff, WI 54568-0470 - Phone
- (715) 356-8000
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3111-024 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3111-024 | WI | Yes |
Addresses
Primary practice location
240 Maple Street
Woodruff, WI 54568-0470
Mailing address
240 Maple Street
PO Box 470
Woodruff, WI 54568-0470
Phone (715) 356-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40183800 | Medicaid | WI |
Other providers in Woodruff, WI
- Mary L Hertel
- Kelsey Hinterleitner
- Yvette K Hittle
- Steven M. Hoffmeister
- Cali Holan
- Elizabeth Lee Horwath
- Howard Young Medical Center Inc of Woodruff Wisconsin
- Howard Young Medical Center Inc of Woodruff Wisconsin
- Ideal Dental Inc.
- Sharon K Iltis
All providers in Woodruff, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.