Individual
LISA JO HOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 W DARBY DR, OTTERBEIN, IN 47970-8563
(765) 583-2505
Mailing address
312 W DARBY DR, OTTERBEIN, IN 47970-8563
(765) 583-2505
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
0510023691
IN
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
About Stedi
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