Healthcare Provider Details

I. General information

NPI: 1811080112
Provider Name (Legal Business Name): GREGORY MICHAEL HOLTZMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 MINER RD
FORT SILL OK
73503-4437
US

IV. Provider business mailing address

2640 MINER RD
FORT SILL OK
73503-4437
US

V. Phone/Fax

Practice location:
  • Phone: 580-248-4212
  • Fax: 580-248-4214
Mailing address:
  • Phone: 580-585-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3742
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: