Individual
TIFFANY K HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCP
Contact information
Practice address
7602 CALLON AVE, WESTON, WI 54476-3213
(715) 393-1252
Mailing address
7602 CALLON AVE, WESTON, WI 54476-3213
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
99-018
WI
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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