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General NPI Number Information
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NPI Number | 1033458567
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Entity Type | Individual
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Provider Name | CHRISTOPHER E HOLBROOK SR.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 10324 US RTE 23
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City | LUCASVILLE
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State | OH
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Zip | 45648
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Country | US
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Telephone | 740-259-0808
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Fax | 740-259-4095
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Provider Business Mailing Address
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Address Line | PO BOX 703
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City | LUCASVILLE
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State | OH
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Zip | 45648-0703
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Country | US
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Telephone | 740-259-0808
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Fax | 740-259-4095
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | HMEL11495
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License Number State | OH
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