MEDICARE: DR. JAMES ABE HOLLAND D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104002003	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	219347	OTHER	VA	ANTHEM BC BS

General Provider Information

NPI Number	:	1013119601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ABE HOLLAND D.C.

Provider Business Mailing Address
First Line	:	11226 PATTERSON AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23238-5011
Country	:	US
Telephone Number	:	804-757-7728
Fax Number	:

Provider Business Practice Location Address
First Line	:	11226 PATTERSON AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23238-5011
Country	:	US
Telephone Number	:	804-757-7728
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	07/09/2007

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