Individual
KAISHA HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
605 SANDRA DRIVE, BROWNS MILLS, NJ 08015
(609) 379-1705
Mailing address
605 SANDRA DR, BROWNS MILLS, NJ 08015-3769
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
H62824248251912
NJ
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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