Individual
DR. PAIGE C. HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2502 E EMPIRE ST, SUITE C, BLOOMINGTON, IL 61704-3738
(309) 664-4444
(309) 664-5006
Mailing address
2502 E EMPIRE ST, SUITE C, BLOOMINGTON, IL 61704-3738
(309) 664-4444
(309) 664-5006
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036116185
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116185
—
IL
Enumeration date
06/29/2006
Last updated
02/25/2014
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