Provider Demographics
NPI:1659466720
Name:RECOB, HOLLY R (DO)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:R
Last Name:RECOB
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:460 S MAIN ST
Mailing Address - City:MOUNT VICTORY
Mailing Address - State:OH
Mailing Address - Zip Code:43340-0367
Mailing Address - Country:US
Mailing Address - Phone:937-354-2027
Mailing Address - Fax:937-354-2029
Practice Address - Street 1:460 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT VICTORY
Practice Address - State:OH
Practice Address - Zip Code:43340-8869
Practice Address - Country:US
Practice Address - Phone:937-354-2027
Practice Address - Fax:937-354-2029
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34005413R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH37347OtherBCBS
OH4324562OtherAETNA
OH4324562OtherAETNA