Individual
MARTHA JO HOLSOMBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
7545 MAIN ST, WOODSTOCK, GA 30188-1615
(770) 928-0133
(770) 928-1663
Mailing address
7545 MAIN ST, WOODSTOCK, GA 30188-1615
(770) 928-0133
(770) 928-1663
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN046903
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00520341B
—
GA
Enumeration date
02/05/2007
Last updated
07/09/2007
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