Individual
JASON HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
147 RICHARD JOINER RD, MENDENHALL, MS 39114-5484
(601) 818-8442
Mailing address
147 RICHARD JOINER RD, MENDENHALL, MS 39114-5484
(601) 818-8442
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
53971
MS
Other
Enumeration date
07/21/2023
Last updated
07/21/2023
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