Provider Demographics
NPI:1063191583
Name:HOLM, CASSANDRA MAY (DC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MAY
Last Name:HOLM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3187 WESTERN ROW RD STE 114
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8014
Mailing Address - Country:US
Mailing Address - Phone:513-770-3434
Mailing Address - Fax:
Practice Address - Street 1:3187 WESTERN ROW RD STE 114
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8014
Practice Address - Country:US
Practice Address - Phone:513-770-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor