Individual
CASEY HOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 FULLER CT, LANCASTER, OH 43130-7852
(740) 215-4624
Mailing address
2944 JACKSON TWP RD 186 SW, JUNCTION CITY, OH 43748
(740) 215-4624
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6401946
—
OH
Enumeration date
10/05/2020
Last updated
10/05/2020
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