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General NPI Number Information
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NPI Number | 1407990401
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Entity Type | Individual
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Provider Name | RUTH HEATHER HOLLIDAY D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12426 GAYTON RD
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City | RICHMOND
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State | VA
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Zip | 23238-2269
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Country | US
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Telephone | 804-741-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 2902 KENWOOD AVE
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City | RICHMOND
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State | VA
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Zip | 23228-5024
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Country | US
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Telephone | 804-398-0288
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Fax |
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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 | 0104555863
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License Number State | VA
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