Individual
LATICIA R HOLLINGSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C, ATC
Contact information
Practice address
106 BLANCA AVE, ORTHOPEDIC DEPARTMENT, ALAMOSA, CO 81101-2340
(719) 589-8091
(719) 589-8012
Mailing address
106 BLANCA AVE, ORTHOPEDIC DEPARTMENT, ALAMOSA, CO 81101-2340
(719) 589-8091
(719) 589-8012
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
934
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82275335
—
CO
Enumeration date
05/27/2005
Last updated
05/04/2021
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