Provider Demographics
NPI:1851593511
Name:OBERHOLZER, CATHARINA JACOBA
Entity Type:Individual
Prefix:MRS
First Name:CATHARINA
Middle Name:JACOBA
Last Name:OBERHOLZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:POMONA PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32181-0309
Mailing Address - Country:US
Mailing Address - Phone:386-336-6511
Mailing Address - Fax:
Practice Address - Street 1:6050 SAINT JOHNS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3895
Practice Address - Country:US
Practice Address - Phone:386-336-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA50305175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath