Healthcare Provider Details

I. General information

NPI: 1861833287
Provider Name (Legal Business Name): CHRISTOPHER LEWIS HOLMES D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2013
Last Update Date: 07/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 MORELAND AVE SE #C-106
ATLANTA GA
30316-7000
US

IV. Provider business mailing address

749 MORELAND AVE SE #C-106
ATLANTA GA
30316-7000
US

V. Phone/Fax

Practice location:
  • Phone: 404-627-8998
  • Fax: 404-627-8970
Mailing address:
  • Phone: 404-627-8998
  • Fax: 404-627-8970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR00008964
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCHIR00008964
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCHIR00008964
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: