Individual provider · NPI-1

Tommy Holt

Community Health Worker · Farmington Hills, MI

NPI number1669261038
StatusActive
Last updated in NPPESMay 2, 2025

Details

NPI
1669261038
Entity type
Individual (NPI-1)
Name
Tommy Holt
Sex
Male
Sole proprietor
Yes
Enumeration date
May 2, 2025
Certification date
May 2, 2025
Last updated
May 2, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Workerh430799162273MIYes

Practice location

33533 W 12 Mile Rd
Farmington Hills, MI 48331-3354

Phone 248-406-0620

Mailing address

23239 Cornerstone Village Dr
Southfield, MI 48075-3684

Phone 313-772-1845

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