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Individual

DR. JAVEN DELANO HOLM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1210 E BLUE EARTH AVE, FAIRMONT, MN 56031-4252
(507) 238-3363
(507) 235-3380
Mailing address
1210 E BLUE EARTH AVE, FAIRMONT, MN 56031-4252
(507) 238-3363
(507) 235-3380

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN2192
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05165110
MN
Enumeration date
06/21/2005
Last updated
04/05/2011
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