Provider Demographics
NPI:1336415231
Name:HOLLY CHIROPRACTIC CENTER P.C.
Entity type:Organization
Organization Name:HOLLY CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:POLLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCI
Authorized Official - Phone:970-522-3500
Mailing Address - Street 1:709 HOLLY DR
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-4541
Mailing Address - Country:US
Mailing Address - Phone:970-522-3500
Mailing Address - Fax:970-522-3509
Practice Address - Street 1:709 HOLLY DR
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4541
Practice Address - Country:US
Practice Address - Phone:970-522-3500
Practice Address - Fax:970-522-3509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1177111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1456-3OtherMEDICARE ID
CO1700956158OtherDR. PHILIP J. POLLOCK INDIVIDUAL NPI
CO1700956158OtherDR. PHILIP J. POLLOCK INDIVIDUAL NPI