Individual
MS. HOLLY LYN SCRIVNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
872 W DAYTON ST, GALESBURG, IL 61401-1503
(309) 344-3400
Mailing address
1222 GARDEN LN, GALESBURG, IL 61401-2127
(309) 368-0877
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
160005266
IL
Other
Enumeration date
08/21/2011
Last updated
08/21/2011
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