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General NPI Number Information
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NPI Number | 1346332467
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Entity Type | Organization
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Legal Business Name | HOLISTIC HEALING ARTS, LLC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2010 HICKORY RIDGE RD
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City | POMONA
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State | IL
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Zip | 62975-2325
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Country | US
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Telephone | 618-893-9150
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Fax | 618-893-1960
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Provider Business Mailing Address
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Address Line | 2010 HICKORY RIDGE RD
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City | POMONA
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State | IL
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Zip | 62975-2325
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Country | US
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Telephone | 618-893-9150
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Fax | 618-893-1960
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Authorized Official
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Title or Position | OWNER / PORVIDER
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Name | LINDA HOSTALEK
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Credential | DO
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Telephone | 618-893-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | IL
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