| Holt's Clinical Team | |
|
134 W 1180 N Ste 12 Tooele UT 84074-1483 | |
| (435) 249-0767 | |
| (435) 249-0754 |
| Full Name | Holt's Clinical Team |
|---|---|
| Speciality | Family Medicine |
| Location | 134 W 1180 N Ste 12, Tooele, Utah |
| Authorized Official Name and Position | Rebecca Holt (OWNER/AO) |
| Authorized Official Contact | 4352490767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holt's Clinical Team 134 W 1180 N Ste 12 Tooele UT 84074-1483 Ph: (435) 249-0767 | Holt's Clinical Team 134 W 1180 N Ste 12 Tooele UT 84074-1483 Ph: (435) 249-0767 |
| NPI Number | 1962070599 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 06/11/2021 |
| Medicare PECOS PAC ID | 5294136263 |
|---|---|
| Medicare Enrollment ID | O20210628002871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962070599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Laura Purdy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093058463 PECOS PAC ID: 9133556624 Enrollment ID: I20210629000936 |
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