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General NPI Number Information
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NPI Number | 1790942282
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Entity Type | Organization
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Legal Business Name | HOLLIDAY CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 500 CIRCLE DR A MANOWN PROFESSIONAL BUILDING
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City | BELLE VERNON
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State | PA
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Zip | 15012-9680
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Country | US
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Telephone | 724-929-8766
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Fax | 724-929-8767
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Provider Business Mailing Address
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Address Line | 500 CIRCLE DR A MANOWN PROFESSIONAL BUILDING
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City | BELLE VERNON
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State | PA
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Zip | 15012-9680
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Country | US
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Telephone | 724-929-8766
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Fax | 724-929-8767
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Authorized Official
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Title or Position | OWNER
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Name | DR. GLEN EDWARD HOLLIDAY
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Credential | D.C.
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Telephone | 724-929-8766
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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 | DC003253L
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License Number State | PA
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