Individual
HEIDI HOLCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
21606
OR
225700000X
Massage Therapist
Primary
21605
OR
Other
Enumeration date
09/21/2015
Last updated
10/24/2017
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