Provider Demographics
NPI:1952491037
Name:HOLM, AARON JEFFREY (RT-R)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:JEFFREY
Last Name:HOLM
Suffix:
Gender:M
Credentials:RT-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ADAMS STREET
Mailing Address - Street 2:UNIT T
Mailing Address - City:CORDOVA
Mailing Address - State:AK
Mailing Address - Zip Code:99574
Mailing Address - Country:US
Mailing Address - Phone:907-424-5959
Mailing Address - Fax:
Practice Address - Street 1:600 ADAMS STREET
Practice Address - Street 2:UNIT T
Practice Address - City:CORDOVA
Practice Address - State:AK
Practice Address - Zip Code:99574
Practice Address - Country:US
Practice Address - Phone:907-424-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography