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General NPI Number Information
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NPI Number | 1619546983
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Entity Type | Individual
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Provider Name | HOLLY CLARA BOCHOW BUSINESS MANAGER
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Gender | Female
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 232 MAIN ST N
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City | PIERZ
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State | MN
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Zip | 56364-1583
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Country | US
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Telephone | 320-468-2221
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Fax | 320-468-7117
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Provider Business Mailing Address
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Address Line | 232 MAIN ST N
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City | PIERZ
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State | MN
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Zip | 56364-1583
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Country | US
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Telephone | 320-468-2221
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Fax | 320-468-7117
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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 | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number | 2959
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License Number State | MN
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