MEDICARE: CONNOR M HOLLENBECK DC

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	0104558151	VA

General Provider Information

NPI Number	:	1083561963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNOR M HOLLENBECK DC

Provider Business Mailing Address
First Line	:	5020 OLDE STONE LN
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28104-3350
Country	:	US
Telephone Number	:	704-776-3904
Fax Number	:

Provider Business Practice Location Address
First Line	:	3543 W BRADDOCK RD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22302-1900
Country	:	US
Telephone Number	:	703-952-5652
Fax Number	:

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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