Provider Demographics
NPI:1194316372
Name:HOLOWISKI, LISA M (DC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:HOLOWISKI
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 1:5105 DTC PKWY STE 305
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2608
Mailing Address - Country:US
Mailing Address - Phone:303-290-0022
Mailing Address - Fax:
Practice Address - Street 1:5105 DTC PKWY STE 305
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2608
Practice Address - Country:US
Practice Address - Phone:303-290-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07244111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX07244OtherTEXAS LICENCE