Individual
AMY HOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
812 W MLK BLVD #100, TAMPA, FL 33603-3338
(813) 224-0525
(813) 224-0622
Mailing address
812 W MLK BLVD #100, TAMPA, FL 33603-3338
(813) 224-0525
(813) 224-0622
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005843900
—
FL
Enumeration date
12/30/2013
Last updated
09/03/2015
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