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Individual

DR. GREGORY VERNON HOLLSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
11444 SEMINOLE BLVD, LARGO, FL 33778-3237
(727) 393-6100
(727) 393-5461
Mailing address
11444 SEMINOLE BLVD, LARGO, FL 33778-3237
(727) 393-6100
(727) 393-5461

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH002658
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051502700
FL
Enumeration date
08/10/2005
Last updated
08/23/2010
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