Individual
MR. JON A HOLZBACHER
Active
Individual
MR. JON A HOLZBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-010266
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000483072
ANTHEM
OH
05
—
2682913
—
OH
01
—
415572
WELLCARE
OH
01
—
P00331815
MEDICARE RAILROAD
OH
Enumeration date
08/07/2006
Last updated
10/02/2012
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