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General NPI Number Information
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NPI Number | 1477858389
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Entity Type | Individual
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Provider Name | MICHAEL JAMES HOLTEL RPH
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Gender | Male
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 690 BETHEL ST
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City | CLOVER
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State | SC
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Zip | 29710-1156
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Country | US
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Telephone | 803-222-1383
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Fax |
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Provider Business Mailing Address
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Address Line | 4454 CYPRESS CV
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City | ROCK HILL
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State | SC
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Zip | 29732-9287
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Country | US
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Telephone | 803-329-2377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 007047
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License Number State | SC
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