Individual
OLAF M HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPO
Contact information
Practice address
812 W MLK BLVD STE 100, TAMPA, FL 33603-3338
(813) 224-0525
(813) 224-0622
Mailing address
812 W MLK BLVD STE 100, TAMPA, FL 33603-3338
(813) 224-0525
(813) 224-0622
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
POR124
FL
224P00000X
Prosthetist
Primary
POR124
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005843900
—
FL
Enumeration date
01/09/2018
Last updated
01/09/2018
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