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General NPI Number Information
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NPI Number | 1437955366
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Entity Type | Individual
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Provider Name | TRISHA HOLLOWAY
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Gender | Female
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 6095 PROFESSIONAL PKWY STE B102
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-5608
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Country | US
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Telephone | 678-303-0136
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Fax | 678-303-0124
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Provider Business Mailing Address
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Address Line | 6095 PROFESSIONAL PKWY STE B102
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-5608
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Country | US
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Telephone | 678-303-0136
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Fax | 678-303-0124
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1101X
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Taxonomy Name | Ophthalmic Assistant
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License Number | 284180
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License Number State | GA
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