Most Relevant Information
Provider Data
| NPI Number: | 1003693474 |
| Provider Name: | KENYATA B HOLTON DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT016871 |
Most Important Dates
| Enumeration Date: | 09/11/2023 |
| Last Updated: | 09/11/2023 |
Provider Practice Location
1157B WEST AVE SW
CONYERS
GA
300125280
Practice Location Phone/Fax
| Phone: | 7709222420 |
| Fax: |
Provider Mailing Location
PO BOX 8068
COLUMBUS
GA
319088068
Provider Mailing Phone/Fax
| Phone: | 7063227762 |
| Fax: |