Healthcare Provider Details

I. General information

NPI: 1922312966
Provider Name (Legal Business Name): TERRY F HOLLAND PROFESSIONAL CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 BRYSON DR
SUTTER CREEK CA
95685-4118
US

IV. Provider business mailing address

14 BRYSON DR
SUTTER CREEK CA
95685-4118
US

V. Phone/Fax

Practice location:
  • Phone: 209-223-2307
  • Fax: 209-267-5565
Mailing address:
  • Phone: 209-223-2307
  • Fax: 209-267-5565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 12707
License Number StateCA

VIII. Authorized Official

Name: DR. TERRY F HOLLAND
Title or Position: PRESIDENT
Credential: DC
Phone: 209-223-2307