Provider Demographics
NPI:1194764910
Name:HOLTZ, MARY K (AP, DOM)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:K
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 SW MAPP RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2754
Mailing Address - Country:US
Mailing Address - Phone:772-678-8250
Mailing Address - Fax:
Practice Address - Street 1:2646 SW MAPP RD
Practice Address - Street 2:SUITE 301
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2754
Practice Address - Country:US
Practice Address - Phone:772-678-8250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP-1269171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist