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General NPI Number Information
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NPI Number | 1285956979
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Entity Type | Organization
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Legal Business Name | DR. BARON HOLT
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 2315 LYNN RD SUITE 103
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City | RALEIGH
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State | NC
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Zip | 27612-6743
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Country | US
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Telephone | 423-748-5095
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Fax |
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Provider Business Mailing Address
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Address Line | 2315 LYNN RD
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City | RALEIGH
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State | NC
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Zip | 27612-6743
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Country | US
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Telephone | 423-748-5095
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BARON GABLE HOLT
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Credential | D. C.
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Telephone | 423-748-5095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 4061
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 4061
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License Number State | NC
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