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Individual

DR. CHARLES B HOLLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6030 GARRETT LN, ROCKFORD, IL 61107-6637
(815) 226-1172
Mailing address
6030 GARRETT LN, ROCKFORD, IL 61107-6637
(815) 226-1172

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036054580
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036054580
IL
Enumeration date
09/01/2006
Last updated
11/25/2013
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