Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | B00739 | NV |
NPI | 1053368779 |
---|---|
Provider Name | Dr. Larry Holt |
First Address | North Las Vegas, NV 89032-5001 |
Second Address | N Las Vegas, NV 89032-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 26/06/2012 |