Healthcare Provider Details

I. General information

NPI: 1831019785
Provider Name (Legal Business Name): ADAM HOLLIDAY ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 WOODSON DR
ERIE CO
80516-6876
US

IV. Provider business mailing address

422 WOODSON DR
ERIE CO
80516-6876
US

V. Phone/Fax

Practice location:
  • Phone: 303-877-6490
  • Fax:
Mailing address:
  • Phone: 303-877-6490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.0000946
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: