Provider Demographics
NPI:1194753483
Name:HOLM, GREGORY ALAN (MS, ATC, CSCS)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:ALAN
Last Name:HOLM
Suffix:
Gender:M
Credentials:MS, ATC, CSCS
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6522 SHADY LANE DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-8583
Mailing Address - Country:US
Mailing Address - Phone:507-285-7577
Mailing Address - Fax:507-280-5577
Practice Address - Street 1:MAYO CLINIC
Practice Address - Street 2:200 FIRST STREET SW
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-285-7577
Practice Address - Fax:507-280-5577
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer