Provider Demographics
NPI:1093513590
Name:JOEL HOLLOW, RD LD
Entity type:Organization
Organization Name:JOEL HOLLOW, RD LD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HOLLOW
Authorized Official - Suffix:
Authorized Official - Credentials:RD LD
Authorized Official - Phone:262-939-9914
Mailing Address - Street 1:3717 MORMON COULEE RD APT 108
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-3885
Mailing Address - Country:US
Mailing Address - Phone:262-939-9914
Mailing Address - Fax:
Practice Address - Street 1:3717 MORMON COULEE RD APT 108
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-3885
Practice Address - Country:US
Practice Address - Phone:262-939-9914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty