Individual
KENNETH RAY HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2002 S HOLT RD, INDIANAPOLIS, IN 46241-4804
(317) 247-3300
Mailing address
2002 S HOLT RD, INDIANAPOLIS, IN 46241-4804
(317) 247-3300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001067A
IN
Other
Enumeration date
02/17/2009
Last updated
05/18/2012
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