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Individual

MR. JASON KEITH HOLT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
30999 COUNTY ROAD 15, LAS ANIMAS, CO 81054-9499
(719) 662-1105
(719) 456-0109
Mailing address
1101 GRACE AVE, LA JUNTA, CO 81050-3119
(719) 468-2734
(719) 456-0109

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
ACB.0007699
CO

Other

Enumeration date
11/06/2013
Last updated
11/06/2013
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