MEDICARE: BRIAN T. HOLMES, D. C. , A CHIROPRACTIC CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC25707	CA

General Provider Information

NPI Number	:	1164576120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN T. HOLMES, D. C. , A CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	2434 FLETCHER PKWY
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-2105
Country	:	US
Telephone Number	:	619-460-6511
Fax Number	:	619-460-6513

Provider Business Practice Location Address
First Line	:	2434 FLETCHER PKWY
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-2105
Country	:	US
Telephone Number	:	619-460-6511
Fax Number	:	619-460-6513

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRIAN TODD HOLMES
Credential	:	D.C.
Telephone Number	:	619-460-6511

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	07/18/2007

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