MEDICARE: DR. HOLLY LYNN SUAREZ 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	5342	MN

General Provider Information

NPI Number	:	1831413780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOLLY LYNN SUAREZ DC

Provider Business Mailing Address
First Line	:	3018 W 56TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55410-2474
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3018 W 56TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55410-2474
Country	:	US
Telephone Number	:	612-925-1649
Fax Number	:

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

Provider Enumeration Date	:	03/22/2010
Last Update Date	:	04/02/2012

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