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General NPI Number Information
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NPI Number | 1184738296
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Entity Type | Organization
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Legal Business Name | HOLMES SPINE & SPORT CHIROPRACTIC CLINIC INC.
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 1245 GLEN DR
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City | MILLERSBURG
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State | OH
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Zip | 44654-8958
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Country | US
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Telephone | 330-674-0444
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Fax | 330-674-0802
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Provider Business Mailing Address
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Address Line | 1245 GLEN DR
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City | MILLERSBURG
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State | OH
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Zip | 44654-8958
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Country | US
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Telephone | 330-674-0444
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Fax | 330-674-0802
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. REX A SMETZER
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Credential |
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Telephone | 330-674-0444
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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 |
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License Number State |
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