Healthcare Provider Details

I. General information

NPI: 1649468893
Provider Name (Legal Business Name): HOLLY CHIROPRACTIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1852 BURLINGTON MOUNT HOLLY RD
WESTAMPTON NJ
08060-1070
US

IV. Provider business mailing address

1852 BURLINGTON MOUNT HOLLY RD
WESTAMPTON NJ
08060-1070
US

V. Phone/Fax

Practice location:
  • Phone: 609-265-8100
  • Fax: 609-265-8369
Mailing address:
  • Phone: 609-265-8100
  • Fax: 609-265-8369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00391500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number38MC00391500
License Number StateNJ

VIII. Authorized Official

Name: DR. SCOTT W. MAHONEY
Title or Position: PRESIDENT
Credential: D.C.
Phone: 609-265-8100