Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 19485 | CA |
Y | 111N00000X | Chiropractor | 2992 | WA |
NPI | 1013040419 |
---|---|
Provider Name | Paul E Holman |
First Address | Hood River, OR 97031-1087 |
Second Address | Bingen, WA 98605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 04/11/2007 |