NPI 1104050657

Charles Edward Holtz, IDMT

Practitioner Independent Duty Medical Technicians Grand Forks Afb, ND

Practice location

Address: 1599 J St, Grand Forks Afb, ND 58205-6306
Phone: (701) 747-5504
Fax: (701) 747-5923
Mailing address: 2026 Spruce Dr Unit a, Grand Forks, ND 58204-1864

Registered specialties

Independent Duty Medical Technicians Primary

Other Service Providers Taxonomy 1710I1003X

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Registry record

NPI: 1104050657
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 May 2009
Record last updated: 13 May 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.