Individual
MATTHEW DALE HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
11330 FOUNTAINS DR, MAPLE GROVE, MN 55369-7200
(763) 494-8059
(763) 494-8056
Mailing address
11330 FOUNTAINS DR, MAPLE GROVE, MN 55369-7200
(763) 494-8059
(763) 494-8056
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116772
MN
Other
Enumeration date
09/24/2011
Last updated
09/24/2011
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