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1053831214
HOLLY VANNITAMBY
PEORIA, IL
NPI
1053831214
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IL 036150954)
Enumeration Date
2017-06-20
Last Update Date
2020-07-27
Business Address
HOLLY VANNITAMBY DO
6339 N BIG HOLLOW RD
PEORIA, IL 61615-2907
Phone number: 309-693-3315
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Mailing Address
HOLLY VANNITAMBY DO
815 MAIN ST STE A
PEORIA, IL 61602-1080
Phone number: 309-672-4977
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