MEDICARE: DR. JAMES M HOLLERN 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	4221	KY

General Provider Information

NPI Number	:	1841248663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES M HOLLERN D.C.

Provider Business Mailing Address
First Line	:	9716 GRANDIN WOODS RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-2378
Country	:	US
Telephone Number	:	502-552-5906
Fax Number	:

Provider Business Practice Location Address
First Line	:	5215 NEW CUT RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40214-3511
Country	:	US
Telephone Number	:	502-552-5906
Fax Number	:

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	09/30/2009

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