Jacob Holman, DPT | |
26672 Portola Pkwy Ste 116, Foothill Ranch, CA 92610-1773 | |
(800) 788-5753 | |
Not Available |
Full Name | Jacob Holman |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 26672 Portola Pkwy Ste 116, Foothill Ranch, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902513286 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Prosport Physical Therapy Professionals Inc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1073170437 PECOS PAC ID: 0749510634 Enrollment ID: O20200304001273 |
Mailing Address | Practice Location Address |
---|---|
Jacob Holman, DPT 23592 Windsong Apt 15c, Aliso Viejo, CA 92656-1368 Ph: (760) 420-5148 | Jacob Holman, DPT 26672 Portola Pkwy Ste 116, Foothill Ranch, CA 92610-1773 Ph: (800) 788-5753 |
Amy Cole, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 27442 Portola Pkwy, Suite 200, Foothill Ranch, CA 92610 Phone: 949-282-5900 | |
Lauren Elizabeth Victor, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 26672 Portola Pkwy Ste 116, Foothill Ranch, CA 92610 Phone: 800-788-5753 | |
Christopher Stalewski, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 27442 Portola Pkwy, 200, Foothill Ranch, CA 92610 Phone: 310-836-8900 | |
Nikita Desai, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 26672 Portola Pkwy Ste 116, Foothill Ranch, CA 92610 Phone: 800-788-5753 | |
Kelly Muller, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 27442 Portola Pkwy Ste 200, Foothill Ranch, CA 92610 Phone: 760-409-6383 | |
Parita Vipul Shah, PT DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 26700 Towne Centre Dr Ste 120, Foothill Ranch, CA 92610 Phone: 949-597-2103 Fax: 949-597-2061 | |
Stephen Mark Ayres, PT DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 26700 Towne Centre Dr Ste 120, Foothill Ranch, CA 92610 Phone: 949-597-2103 Fax: 949-597-2061 |