MEDICARE: DR. DANA MARIE HOLM D.C.

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	1114	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679783732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANA MARIE HOLM D.C.

Provider Business Mailing Address
First Line	:	2701 S. MINNESOTA AVE.
Second Line	:	SUITE 3
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-4746
Country	:	US
Telephone Number	:	404-271-9527
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 S. MINNESOTA AVE.
Second Line	:	SUITE 3
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-4746
Country	:	US
Telephone Number	:	404-271-9527
Fax Number	:

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	05/19/2010

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