Individual
JAVON HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
696 AYLESBURY DR, VIRGINIA BEACH, VA 23462-7182
(757) 439-2028
Mailing address
696 AYLESBURY DR, VIRGINIA BEACH, VA 23462-7182
(757) 439-2028
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T60568686
VA
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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