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1114255064
JOHNATHAN HOLMAN
BLOOMER, WI
NPI
1114255064
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 1216-019)
Enumeration Date
2009-12-03
Last Update Date
2009-12-03
Business Address
-- JOHNATHAN HOLMAN PTA
1402 MAIN ST BOX 176
BLOOMER, WI 54724-1637
Phone number: 715-568-4669
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Mailing Address
-- JOHNATHAN HOLMAN PTA
1402 MAIN ST PO BOX 176
BLOOMER, WI 54724-1637
Phone number: 715-568-4669
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