MEDICARE: DR. MARCIA ANN HOLLETT 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	CH 0005490	FL

General Provider Information

NPI Number	:	1972597722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCIA ANN HOLLETT DC

Provider Business Mailing Address
First Line	:	3089 NW 4TH AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-6722
Country	:	US
Telephone Number	:	954-579-0180
Fax Number	:	888-921-2667

Provider Business Practice Location Address
First Line	:	3313 GOLDA CIR
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33917-7153
Country	:	US
Telephone Number	:	239-233-9898
Fax Number	:	888-921-2667

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	05/19/2011

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