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General NPI Number Information
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NPI Number | 1124586706
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Entity Type | Individual
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Provider Name | COURTNEY NICOLE HOLUB D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 2837 DARLING CT
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City | LA CROSSE
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State | WI
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Zip | 54601-2754
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Country | US
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Telephone | 608-783-3040
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Fax | 844-248-2389
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Provider Business Mailing Address
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Address Line | 2837 DARLING CT
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City | LA CROSSE
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State | WI
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Zip | 54601-2754
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Country | US
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Telephone | 608-783-3040
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Fax | 844-248-2389
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5438
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License Number State | WI
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