Individual
JENNIFER N. HOLSAPPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 W WHITTAKER ST, SALEM, IL 62881-1915
(618) 548-2255
(618) 548-6303
Mailing address
1104 W WHITTAKER ST, SALEM, IL 62881-1915
(618) 548-2255
(618) 548-6303
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1264360001
EOB
IL
Enumeration date
02/06/2007
Last updated
07/08/2007
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