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NPI Code Detail

MEDICARE: LAURIE ELIZABETH HOLM

MEDICARE: LAURIE ELIZABETH HOLM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1518169440
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE ELIZABETH HOLM
Provider Business Mailing Address
First Line : 1109 N SYCAMORE AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57110-5750
Country : US
Telephone Number : 605-371-2744
Fax Number :
Provider Business Practice Location Address
First Line : 1109 N SYCAMORE AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57110-5750
Country : US
Telephone Number : 605-371-2744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 07/08/2007

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Directions to “ LAURIE ELIZABETH HOLM ” Practice Location

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