Provider Demographics
NPI:1922298801
Name:HOLGERS, JASON D C (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:D C
Last Name:HOLGERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 BEAM AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1128
Mailing Address - Country:US
Mailing Address - Phone:651-326-5444
Mailing Address - Fax:651-326-5520
Practice Address - Street 1:1747 BEAM AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1128
Practice Address - Country:US
Practice Address - Phone:651-326-5444
Practice Address - Fax:651-326-5520
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4088208100000X
MN57575208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation