Provider Demographics
NPI:1679387393
Name:HOLCOMB, GLENDA B (PT, DPT, CLT)
Entity type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:B
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9475 LISTOW TER
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2717
Mailing Address - Country:US
Mailing Address - Phone:561-509-4088
Mailing Address - Fax:
Practice Address - Street 1:9475 LISTOW TER
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-2717
Practice Address - Country:US
Practice Address - Phone:561-509-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT017071225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist