Organization
MAIN STREET MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE LYNN HOLMAN NP (NP)
(618) 435-4310
Entity
Organization
Contact information
Practice address
505 N MAIN ST, BENTON, IL 62812-1102
(618) 435-4310
(618) 435-4384
Mailing address
505 N MAIN ST, BENTON, IL 62812-1102
(618) 435-4310
(618) 435-4384
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
IL
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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