Individual provider · Type 1 NPI

Coty John Holm

Surgical Physician Assistant · Missoula, MT

NPI number 1902453855 Active

Practice location

500 W Broadway St
Missoula, MT 59802-4008

Call (406) 329-5615 Map

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012

Other practice locations

  • 4311 11th Avenue NE, Suite 200, Seattle, WA 98105-6367 · (206) 616-4001

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XMED-PAC-LIC-91036 (MT)
Student in an Organized Health Care Education/Training Program 390200000XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1902453855

Coty John Holm's National Provider Identifier is 1902453855, issued on Aug 23, 2019. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Missoula, MT. The record was last updated on May 21, 2021.