Provider Demographics
NPI:1659054674
Name:HOLTZ, CLAIRE ASHLEY (RPH)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ASHLEY
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RICHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IA
Mailing Address - Zip Code:52345-9021
Mailing Address - Country:US
Mailing Address - Phone:319-558-7657
Mailing Address - Fax:
Practice Address - Street 1:1825 E SAN MARNAN DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-4307
Practice Address - Country:US
Practice Address - Phone:319-235-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist