Provider Demographics
NPI:1528886504
Name:HOLTHUS, DAISY MICHALSKI
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:MICHALSKI
Last Name:HOLTHUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2388 PINECREST AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5231
Mailing Address - Country:US
Mailing Address - Phone:858-775-3417
Mailing Address - Fax:
Practice Address - Street 1:30555 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5310
Practice Address - Country:US
Practice Address - Phone:734-629-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program