Individual
ELOISE W HOLLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MNT
Contact information
Practice address
812 GORMAN AVENUE, ELKINS, WV 26241
(304) 636-3300
Mailing address
812 GORMAN AVENUE, ELKINS, WV 26241
(304) 636-3300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
392970
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00422763
RAILROAD MEDICARE
WV
Enumeration date
11/09/2006
Last updated
01/14/2008
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