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Individual

MR. BRENT CHARLES HOLTGREWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS., BSC., LAT, ATC

Contact information

Practice address
209 RUE SAINT LOUIS, FLORISSANT, MO 63031-5025
(314) 596-2656
Mailing address
209 RUE SAINT LOUIS, FLORISSANT, MO 63031-5025
(314) 596-2656

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2016022071
MO
2255A2300X
Athletic Trainer
AL1968
FL

Other

Enumeration date
02/06/2008
Last updated
09/05/2023
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