Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 6808 | CO |
NPI | 1124391214 |
---|---|
Provider Name | Julie Marie Holland |
First Address | Golden, CO 80401-2712 |
Second Address | Golden, CO 80401-2712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2012 |
Last Update Date | 20/02/2012 |