Provider Demographics
NPI:1740482256
Name:HOLT, JOHN ATKINSON JR (LAC, DIPL OM, LMT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ATKINSON
Last Name:HOLT
Suffix:JR
Gender:M
Credentials:LAC, DIPL OM, LMT
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 2461
Mailing Address - Street 2:
Mailing Address - City:TELLURIDE
Mailing Address - State:CO
Mailing Address - Zip Code:81435-2461
Mailing Address - Country:US
Mailing Address - Phone:970-728-1442
Mailing Address - Fax:
Practice Address - Street 1:220 SOUTH PINE ST.
Practice Address - Street 2:
Practice Address - City:TELLURIDE
Practice Address - State:CO
Practice Address - Zip Code:81435-2461
Practice Address - Country:US
Practice Address - Phone:970-728-1442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2010-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1268171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO640961752OtherANTHEM BLUE CROSS AND BLUE SHIELD