MEDICARE: MRS. HOLLY BETH DONALDSON 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	HD006072	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950B85201	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457343691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HOLLY BETH DONALDSON DC

Provider Business Mailing Address
First Line	:	335 DAVIS ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-3066
Country	:	US
Telephone Number	:	231-929-1335
Fax Number	:	231-929-1336

Provider Business Practice Location Address
First Line	:	335 DAVIS ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-3066
Country	:	US
Telephone Number	:	231-929-1335
Fax Number	:	231-929-1336

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	11/14/2022

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Directions to “ MRS. HOLLY BETH DONALDSON DC” Practice Location

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