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Individual

WADE HOLLOWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
259 JONESBORO RD, MCDONOUGH, GA 30253-3769
(770) 957-8666
Mailing address
1065 JODECO RD, STOCKBRIDGE, GA 30281-4953
(678) 284-6300
(678) 284-6282

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003206
GA

Other

Enumeration date
12/20/2006
Last updated
07/08/2007
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