Provider Demographics
NPI:1699896126
Name:HOLLAND, JOHN HUGH (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HUGH
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2086 ADDISON AVE E
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5306
Mailing Address - Country:US
Mailing Address - Phone:208-737-9397
Mailing Address - Fax:208-737-9398
Practice Address - Street 1:2086 ADDISON AVE E
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5306
Practice Address - Country:US
Practice Address - Phone:208-737-9397
Practice Address - Fax:208-737-9398
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-814111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation