Johnathan Holman, PTA

NPI #1114255064 in Bloomer, Wisconsin

Provider Information

NPI Number: 1114255064
Entity Type: Individual
Name: Johnathan Holman, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Dec 3, 2009
Last Updated: Dec 3, 2009

Practice Location

Address: 1402 MAIN ST
Address 2: BOX 176
City: Bloomer
State: Wisconsin
ZIP Code: 54724-1637
Phone: (715) 568-4669

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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