NPI 1285630632

Javen Delano Holm, OD

Practitioner Optometrist Fairmont, MN

Practice location

Address: 1210 E Blue Earth Ave, Fairmont, MN 56031-4252
Phone: (507) 238-3363
Fax: (507) 235-3380

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence MN2192 (MN)

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Registry record

NPI: 1285630632
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Jun 2005
Record last updated: 5 Apr 2011

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.