Individual
MR. PHILLIP MICHAEL HOLDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
(239) 791-1586
Mailing address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
(239) 791-1586
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5202955
FL
Other
Enumeration date
10/15/2013
Last updated
10/15/2013
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