Healthcare Provider Details

I. General information

NPI: 1326138017
Provider Name (Legal Business Name): MATTHEW A HOLTEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7626 PARAGON RD
CENTERVILLE OH
45459-4049
US

IV. Provider business mailing address

10524 CRAINS CREEK RD
MIAMISBURG OH
45342-0840
US

V. Phone/Fax

Practice location:
  • Phone: 937-435-8480
  • Fax:
Mailing address:
  • Phone: 937-353-3080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2369
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: