Individual
TATUM JUSTINE HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1414 MARYLAND AVE E, SAINT PAUL, MN 55106-2824
(651) 793-5613
Mailing address
1414 MARYLAND AVE E, SAINT PAUL, MN 55106-2824
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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