Most Relevant Information
Provider Data
| NPI Number: | 1003455379 |
| Provider Name: | BILLIE JAY HOLLOWAY |
| Entity Type: | Individual |
| Taxonomy Code: | 3747A0650X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/03/2020 |
| Last Updated: | 01/03/2020 |
Provider Practice Location
1357 HWY 9 SOUTH
PONTOTOC
MS
38863
Practice Location Phone/Fax
| Phone: | 6623435624 |
| Fax: |
Provider Mailing Location
1357 HWY 9 SOUTH
PONTOTOC
MS
38863
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |