Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1861065690 |
---|---|
Provider Name | Holsey James II |
First Address | Muskegon, MI 49442-1338 |
Second Address | Muskegon, MI 49441-2426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2021 |
Last Update Date | 20/07/2021 |