Provider Demographics
NPI:1033193644
Name:HOLMES, MARK D (DPT)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:D
Last Name:HOLMES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8089 S LINCOLN ST STE 207
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2720
Mailing Address - Country:US
Mailing Address - Phone:303-347-1271
Mailing Address - Fax:303-347-1194
Practice Address - Street 1:8089 S LINCOLN ST STE 207
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2720
Practice Address - Country:US
Practice Address - Phone:303-347-1271
Practice Address - Fax:303-347-1194
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CO6239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC800279Medicare ID - Type Unspecified