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1619957164
LISA MICHELLE HOLTSCLAW
FORT WAYNE, IN
NPI
1619957164
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 02001568A)
Enumeration Date
2006-01-19
Last Update Date
2020-06-22
Business Address
LISA MICHELLE HOLTSCLAW D.O.
436 E WASHINGTON BLVD
FORT WAYNE, IN 46802-3210
Phone number: 260-209-7111
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Mailing Address
LISA MICHELLE HOLTSCLAW D.O.
30 W MONROE ST STE 1200
CHICAGO, IL 60603-2420
Phone number: 312-733-9730
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