IndividualActive
Charles Holtz, IDMT
NPI 1104050657 · Independent Duty Medical Technicians · Grand Forks Afb, ND
Provider details
- NPI number
- 1104050657
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- No
Practice location
1599 J St
Grand Forks Afb, ND 58205-6306
Phone: (701) 747-5504
Fax: (701) 747-5923
Mailing address
2026 Spruce Dr
Grand Forks, ND 58204-1864
Registry dates
- Enumerated
- 2009-05-13
- Last updated
- 2009-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.