Individual
DR. MELISSA MARLO HOLLIMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1203 N EASTMAN RD, KINGSPORT, TN 37664-3145
(423) 967-2683
(423) 247-3631
Mailing address
1203 N EASTMAN RD, KINGSPORT, TN 37664-3145
(423) 967-2683
(423) 247-3631
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2021
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010110190
—
VA
01
—
208063482
UNITED
TN
05
—
3945553
—
TN
01
—
4142567
BLUE CROSS / BLUE SHIELD
TN
01
—
6235685
CIGNA
TN
01
—
7106484
AETNA
TN
Enumeration date
09/20/2005
Last updated
08/19/2008
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