Provider Demographics
NPI:1144316597
Name:HOLDGREVE, JAMES R (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:HOLDGREVE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 BERLIN DR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MI
Mailing Address - Zip Code:49274-9736
Mailing Address - Country:US
Mailing Address - Phone:517-283-2227
Mailing Address - Fax:
Practice Address - Street 1:4716 BERLIN DR
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MI
Practice Address - Zip Code:49274-9736
Practice Address - Country:US
Practice Address - Phone:517-283-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist