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Individual

AMANDA LYNN HOLLOWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
126 E MAIN ST STE B, PAYSON, AZ 85541-5488
(928) 468-8610
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 522-9879
(928) 522-9880

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
008289
AZ
390200000X
Student in an Organized Health Care Education/Training Program
009528503
LA

Other

Enumeration date
04/12/2017
Last updated
03/22/2021
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