Individual
LARS E HOLMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1505 MERIDIAN AVE STE A, SAN JOSE, CA 95125-5353
(408) 264-6643
Mailing address
1505 MERIDIAN AVE STE A, SAN JOSE, CA 95125-5353
(408) 264-6643
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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