Individual
CHAD D. HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2115 S FREMONT AVE, SUITE 5000, SPRINGFIELD, MO 65804-2239
(417) 820-3960
(417) 820-3966
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2015006588
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01509555
RR MEDICARE
MO
05
—
PENDING
—
MO
Enumeration date
03/10/2015
Last updated
11/18/2015
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