Most Relevant Information
Provider Data
| NPI Number: | 1003326489 |
| Provider Name: | MICHAEL DAVID HOLT |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/11/2017 |
| Last Updated: | 10/11/2017 |
Provider Practice Location
1175 E MAIN ST
MEDFORD
OR
975047499
Practice Location Phone/Fax
| Phone: | 5417720127 |
| Fax: |
Provider Mailing Location
715 SW RAMSEY AVE
GRANTS PASS
OR
975275500
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |