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1265051171
BRENT HOLLOWAY
IDAHO FALLS, ID
NPI
1265051171
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-04-10
Last Update Date
2020-04-10
Business Address
BRENT HOLLOWAY
1301 E 17TH ST
IDAHO FALLS, ID 83404-6273
Phone number: 208-538-3122
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Mailing Address
BRENT HOLLOWAY
1995 E 17TH ST
IDAHO FALLS, ID 83404-6493
Phone number:
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