Individual
JOHNATHAN HOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1402 MAIN ST, BOX 176, BLOOMER, WI 54724-1637
(715) 568-4669
(715) 568-4673
Mailing address
1402 MAIN ST, PO BOX 176, BLOOMER, WI 54724-1637
(715) 568-4669
(715) 568-4673
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1216-019
WI
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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