Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 35814 | TN |
NPI | 1598859894 |
---|---|
Provider Name | Lorin G Holst |
First Address | Knoxville, TN 37932-1549 |
Second Address | Knoxville, TN 37909-2543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 23/02/2017 |