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Individual

MR. MAX GARY HOLLER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
L.A.T.

Contact information

Practice address
1206 W 11TH ST, FREEPORT, TX 77541-5346
(979) 230-0291
Mailing address
1206 W 11TH ST, FREEPORT, TX 77541-5346
(979) 230-0291

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0747
TX

Other

Enumeration date
10/14/2005
Last updated
07/08/2007
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