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NPI Code Detail

MEDICARE: DR. WILLIAM AUGUSTINE HOLLAND D.C.

MEDICARE: DR. WILLIAM AUGUSTINE 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
1111N00000XChiropractorX008934-0NY
2111N00000XChiropractorCH12486FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2161552265OTHERNYTAX ID
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376636761
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM AUGUSTINE HOLLAND D.C.
Provider Business Mailing Address
First Line : 711 PARK AVE
Second Line :
City : MEDINA
State : NY
Zip : 14103-1036
Country : US
Telephone Number : 585-798-5116
Fax Number : 585-798-5159
Provider Business Practice Location Address
First Line : 302 W FLETCHER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-3415
Country : US
Telephone Number : 585-798-5116
Fax Number : 585-798-5159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2006
Last Update Date : 08/30/2019

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