Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 5883 | AZ |
N | 111NI0900X | Internist | 5883 | AZ |
N | 111NN0400X | Neurology | 5883 | AZ |
N | 111NN1001X | Nutrition | 5883 | AZ |
N | 111NR0200X | Radiology | 5883 | AZ |
N | 213ER0200X | Radiology | 5883 | AZ |
N | 111NS0005X | Chiropractic Sports Physician | 5883 | AZ |
N | 111NT0100X | Thermography | 5883 | AZ |
N | 111NX0100X | Occupational Health | 5883 | AZ |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 5883 | AZ |
NPI | 1316966831 |
---|---|
Provider Name | Dr. Melody A. Holladay |
First Address | Sedona, AZ 86336-4166 |
Second Address | Sedona, AZ 86336-4166 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0941490 | (02) | AZ |