Individual
MATTHEW BRAXTON HOLLOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT(R)
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-6640
Mailing address
5402 HOLLYHOCK LN, BOSSIER CITY, LA 71112-4922
(318) 347-7635
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
9896
LA
Other
Enumeration date
10/04/2022
Last updated
09/19/2024
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