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General NPI Number Information
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NPI Number | 1851483242
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Entity Type | Individual
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Provider Name | JACOB P HOLKUP DC
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 110 S CENTRAL AVE
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City | BEACH
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State | ND
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Zip | 58621-4001
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Country | US
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Telephone | 701-872-7520
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Fax | 701-872-7521
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Provider Business Mailing Address
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Address Line | PO BOX 908
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City | BEACH
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State | ND
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Zip | 58621-0908
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Country | US
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Telephone | 701-872-7520
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Fax | 701-872-7521
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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 | 729
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301009112
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4356
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License Number State | MN
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