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Individual

HOLLY SALLOGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
130001277
DE
152W00000X
Optometrist
Primary
OE008544T
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000038423
DE
01
20389
MID ATLANTIC CHRISTIANA
DE
01
DE1277
EYE MED INS CO
DE
Enumeration date
02/17/2006
Last updated
11/14/2016
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