Holcomb, Russell David

Holcomb, Russell David is an individual health care provider with primary practice located at 95 Hickory Springs Ind Dr , Canton GA 30115-7933. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist is his primary health care specialty. Holcomb, Russell David can be contacted via phone (770) 345-6899.

Contact Information

Primary practice address
95 Hickory Springs Ind Dr Canton GA 30115-7933
Phone: (770) 345-6899
Fax: (770) 345-7341
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X 003 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X 003 Georgia

Profile Details

NPI number 1477610475
LBN Legal business name Holcomb, Russell David
Credentials LCPO
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477610475 NPPES
North Carolina MEDICAID 7700620

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