Individual
DERRIK HOLLADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
65 RIVERTON COMMONS DR, FRONT ROYAL, VA 22630-6768
(540) 635-0700
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2896
(540) 536-5100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110006089
VA
Other
Enumeration date
02/13/2018
Last updated
02/28/2021
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