Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 8387 | MN |
NPI | 1619205515 |
---|---|
Provider Name | Ms. Carolyn Strand Holm |
First Address | Saint Paul, MN 55102-2344 |
Second Address | Saint Paul, MN 55102-2344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2009 |
Last Update Date | 31/05/2019 |