MEDICARE: DR. JAMES ELGIN HOLLINGSWORTH 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	C-482	ID

General Provider Information

NPI Number	:	1982792735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ELGIN HOLLINGSWORTH D.C.

Provider Business Mailing Address
First Line	:	10451 W GARVERDALE CT
Second Line	:	STE. 203
City	:	BOISE
State	:	ID
Zip	:	83704-5408
Country	:	US
Telephone Number	:	208-375-4415
Fax Number	:	208-375-4419

Provider Business Practice Location Address
First Line	:	10451 W GARVERDALE CT
Second Line	:	STE. 203
City	:	BOISE
State	:	ID
Zip	:	83704-5408
Country	:	US
Telephone Number	:	208-375-4415
Fax Number	:	208-375-4419

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/08/2007

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