Healthcare Provider Details

I. General information

NPI: 1346034063
Provider Name (Legal Business Name): DAVID HOLM DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 11TH AVE S STE 24
GREAT FALLS MT
59405-5263
US

IV. Provider business mailing address

PO BOX 6010
GREAT FALLS MT
59406-6010
US

V. Phone/Fax

Practice location:
  • Phone: 406-771-6300
  • Fax: 406-731-8318
Mailing address:
  • Phone: 406-771-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number173564
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: