Healthcare Provider Details

I. General information

NPI: 1609207109
Provider Name (Legal Business Name): ELEANOR HOLDNACK D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 09/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 PISCATAWAY RD STE 305
CLINTON MD
20735-2549
US

IV. Provider business mailing address

5252 LYNGATE CT STE 203
BURKE VA
22015-1672
US

V. Phone/Fax

Practice location:
  • Phone: 301-877-2323
  • Fax: 301-877-2366
Mailing address:
  • Phone: 703-239-2300
  • Fax: 703-239-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number012451
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS03822
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH030147
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104557214
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: