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General NPI Number Information
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NPI Number | 1144659517
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Entity Type | Organization
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Legal Business Name | ALLISON HOLT MD, PA
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 261 SCHOOL AVE SUITE 220
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City | EXCELSIOR
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State | MN
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Zip | 55331-1932
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Country | US
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Telephone | 952-467-6214
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Fax |
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Provider Business Mailing Address
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Address Line | 261 SCHOOL AVE SUITE 220
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City | EXCELSIOR
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State | MN
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Zip | 55331-1932
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Country | US
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Telephone | 952-467-6214
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALLISON ROSE HOLT
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Credential | MD
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Telephone | 952-467-6214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 48144
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License Number State | MN
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