Terra Jayne Holderman, PT, DPT

Individual provider Active NPI Orthopedic Physical Therapist · Mechanicsville, VA

NPI 1124630157 · NPPES record last updated Oct 19, 2020

Key facts

NPI
1124630157
Entity type
Individual (NPI type 1)
Primary specialty
Orthopedic Physical Therapist 2251X0800X
License
2305213668 (VA)
Practice address
8200 Meadowbridge Rd Ste 100
Mechanicsville, VA 23116-2337
Phone
(804) 559-7467
NPI assigned
Aug 20, 2020
Sex
Female
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2305213668 VA Yes

Addresses

Primary practice location

8200 Meadowbridge Rd Ste 100
Mechanicsville, VA 23116-2337

Mailing address

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225-4067
Phone (804) 915-4607

Other identifiers

IdentifierTypeStateIssuer
2305213668OtherVAVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS

Other providers in Mechanicsville, VA

All providers in Mechanicsville, VA · Orthopedic Physical Therapist in Virginia

Sources for this page

Verify at the official NPI Registry.