MEDICARE: DR. ETHAN HUNTER HOLM 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	7389	MN
2	111N00000X	Chiropractor	2945	AL

General Provider Information

NPI Number	:	1679431167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ETHAN HUNTER HOLM DC

Provider Business Mailing Address
First Line	:	203 NARROWS PKWY STE A
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-8649
Country	:	US
Telephone Number	:	763-482-3774
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 NARROWS PKWY STE A
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-8649
Country	:	US
Telephone Number	:	205-419-1595
Fax Number	:

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	02/11/2026

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