Provider Information for 1720381494
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OSA JILL HOLMES
Sex: Female
NPI: 1720381494
Last Updated: 2010-12-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1720381494 | ||||||||
| Enumeration Date | 2010-12-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 909 SE MADISON AVE STUART, FL 34996-3264 United States Phone: 772-214-0196 | Fax: | ||||||||
| Primary Practice Address | 1870 FOREST HILL BLVD STE 200 WEST PALM BEACH, FL 33406-8901 United States Phone: 561-904-6514 | Fax: | ||||||||
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