Individual
MR. CHARLES MATTHEW HOLLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2620 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3396
(573) 785-7721
Mailing address
247 COUNTY ROAD 738, BROOKLAND, AR 72417-8522
(870) 919-7311
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2010014759
MO
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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