Provider Demographics
NPI:1487499786
Name:HOLMES, HELEN ANNETTE (LMT)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:ANNETTE
Last Name:HOLMES
Suffix:
Gender:X
Credentials:LMT
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:CRADDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:169 LOCUST ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4850
Mailing Address - Country:US
Mailing Address - Phone:360-850-2679
Mailing Address - Fax:
Practice Address - Street 1:4050 WILLISTON RD STE 133
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6064
Practice Address - Country:US
Practice Address - Phone:802-863-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT6551172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist