Individual
MS. DIANA R. HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
693 CIRA CT, ST AUGUSTINE, FL 32086-7714
(904) 797-3133
Mailing address
693 CIRA CT, SAINT AUGUSTINE, FL 32086-7714
(904) 797-3133
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 18395
FL
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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