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Individual

NICOLE R HOLZWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102379
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
670001926
RAILROAD MEDICARE
MN
05
854430100
MN
05
ENROLLED
IA
05
ENROLLED
WI
Enumeration date
02/14/2006
Last updated
04/05/2011
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