MEDICARE: DR. HOLLY GANLEY DC

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	CH13108	FL

General Provider Information

NPI Number	:	1437787454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOLLY GANLEY DC

Provider Business Mailing Address
First Line	:	12486 WEEPING BRANCH CIR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-9602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12486 WEEPING BRANCH CIR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-9602
Country	:	US
Telephone Number	:	813-327-2242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2020
Last Update Date	:	03/27/2020

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Directions to “ DR. HOLLY GANLEY DC” Practice Location

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