=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295925519
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOLLAR ENTERPRISES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2007
-----------------------------------------------------
Last Update Date | 04/02/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2505 EVELYN BYRD AVE SUITE B
-----------------------------------------------------
City | HARRISONBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22801-3493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-574-6166
-----------------------------------------------------
Fax | 540-574-6018
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2248
-----------------------------------------------------
City | HARRISONBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22801-9507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-574-6166
-----------------------------------------------------
Fax | 540-574-6018
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. JEFFREY ALLAN HOLLAR
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 540-574-6166
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 0104556047
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------