Individual
DR. JOHN MILLER HOLMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4765 S ICHABOD ST, SALT LAKE CITY, UT 84117-6461
(801) 231-0842
Mailing address
1201 W WRIGHTWOOD AVE APT 18, CHICAGO, IL 60614-1290
(773) 388-2297
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
163812-1205
UT
Other
Enumeration date
09/21/2014
Last updated
09/21/2014
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