Healthcare Provider Details

I. General information

NPI: 1881895746
Provider Name (Legal Business Name): HOLT CHIROPRACTIC OFFICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 MCLEAN AVE
YONKERS NY
10704-3855
US

IV. Provider business mailing address

675 MCLEAN AVE
YONKERS NY
10704-3855
US

V. Phone/Fax

Practice location:
  • Phone: 914-964-5771
  • Fax: 914-964-5773
Mailing address:
  • Phone: 914-964-5771
  • Fax: 914-964-5773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number003146
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberX1932
License Number StateNY

VIII. Authorized Official

Name: DR. BRIAN PATRICK HOLT
Title or Position: PRESIDENT
Credential: D.C.
Phone: 914-964-5771