Organization
MAIN STREET MEDICAL CLINIC LLC
Active
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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