Individual
MR. THOMAS WILLIAM HOLTGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.P.N.
Contact information
Practice address
545 N BUS US HWY 65, STE. 504, BRANSON, MO 65616-4500
(417) 335-2080
(417) 336-3583
Mailing address
545 N BUS US HWY 65, STE. 504, BRANSON, MO 65616-4500
(417) 335-2080
(417) 336-3583
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
066289
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423691567
—
MO
Enumeration date
07/18/2005
Last updated
11/05/2012
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