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Individual
THOMAS R HOLTACKERS
Active
Individual
THOMAS R HOLTACKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1033
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650023815
RAILROAD MEDICARE
MN
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
05
—
ENROLLED
—
WI
Enumeration date
01/09/2006
Last updated
04/18/2011
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