Individual
MR. ISAIAH LAMONE HOLLOWAY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
43 JEROME RD, UNCASVILLE, CT 06382-2311
(860) 892-8127
Mailing address
43 JEROME RD, UNCASVILLE, CT 06382-2311
(860) 892-8127
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/08/2011
Last updated
11/08/2011
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