| Doctor Name: | DENISE BIRKHOLZ |
| NPI Number: | 1649504747 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNIM |
| License Number: | 2138 CNIM |
| Business Practice Address: | 11227 Stella Blue Dr Lolo, MT - 598478490 |
| Business Phone Number: | 3035945123 |
| Business Fax Number: | |
| Mailing Address: | 11227 Stella Blue Dr, LOLO |
| State: | MT |
| Postal Code: | 598478490 |
| Phone Number: | 3035945123 |
| Fax Number: | |
| NPI Enumeration Date: | 09/23/2009 |
| NPI Last Update Date: | 08/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2472E0500X |
| License Number: | 2138 CNIM |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Other |
| Taxonomy Specialization: | EEG |
| Taxonomy Definition: | |