Individual
ELIZABETH LAZIER HOLTBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
450 WILLIAMS WAY, MOAB, UT 84532-2185
(435) 719-3500
Mailing address
450 WILLIAMS WAY, MOAB, UT 84532-2185
(435) 719-3500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
323
CO
363AM0700X
Medical Physician Assistant
Primary
8576577-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027031
KAISER COMMERCIAL NUMBER
CO
05
—
07003239
—
CO
05
—
1255467379
—
UT
Enumeration date
02/25/2007
Last updated
11/23/2021
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