MEDICARE: DR. DONALD ERIC HOLDRIDGE 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	TX 2611	TX

General Provider Information

NPI Number	:	1740291731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD ERIC HOLDRIDGE D.C.

Provider Business Mailing Address
First Line	:	4916 KNICKERBOCKER RD
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76904-7517
Country	:	US
Telephone Number	:	325-949-1112
Fax Number	:	325-949-5551

Provider Business Practice Location Address
First Line	:	4916 KNICKERBOCKER RD
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76904-7517
Country	:	US
Telephone Number	:	325-949-1112
Fax Number	:	325-949-5551

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/14/2010

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