Individual
TASHA HOLLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
801 BRIM ST, DESLOGE, MO 63601-3441
(573) 431-0223
Mailing address
417 GLEN ECHO DR, DE SOTO, MO 63020-3972
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2007022378
MO
Other
Enumeration date
04/03/2018
Last updated
04/03/2018
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