Individual
DR. JARED T HOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(800) 281-3903
Mailing address
1130 CENTURY DR STE E, EDWARDSVILLE, IL 62025-3699
(618) 971-7919
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.017838
IL
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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