Provider Demographics
NPI:1912513797
Name:RASMUSSON, HOLLY ANN (LMT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:RASMUSSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 2ND AVE E
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-1714
Mailing Address - Country:US
Mailing Address - Phone:563-419-0209
Mailing Address - Fax:
Practice Address - Street 1:806 3RD ST W
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1053
Practice Address - Country:US
Practice Address - Phone:563-547-3624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist