Individual provider · NPI-1

Tina M Holba, ATC

Specialist/Technologist, Athletic Trainer · Palos Heights, IL

NPI number1720056542
StatusActive
Last updated in NPPESJun 30, 2014

Details

NPI
1720056542
Entity type
Individual (NPI-1)
Name
Mrs. Tina M Holba
Credential
ATC
Sex
Female
Sole proprietor
No
Enumeration date
Mar 8, 2006
Last updated
Jun 30, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer096001810ILYes

Practice location

13049 S Ridgeland Ave
Palos Heights, IL 60463-2625

Phone 708-371-1111

Mailing address

13049 S Ridgeland Ave
Palos Heights, IL 60463-2625

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