Provider Demographics
NPI:1962545640
Name:HOLT CHIROPRACTIC OFFICES, P.C.
Entity type:Organization
Organization Name:HOLT CHIROPRACTIC OFFICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-620-0939
Mailing Address - Street 1:300 N MIDDLETOWN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1262
Mailing Address - Country:US
Mailing Address - Phone:845-620-0939
Mailing Address - Fax:845-620-0940
Practice Address - Street 1:300 N MIDDLETOWN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1262
Practice Address - Country:US
Practice Address - Phone:845-620-0939
Practice Address - Fax:845-620-0940
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLT CHIROPRACTIC OFFICES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-14
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX001932111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
X0W031Medicare PIN