Individual
ANNA GONGJOO HOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112-5888
(801) 664-1439
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/28/2023
Last updated
04/02/2026
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