Provider Demographics
NPI:1073965901
Name:DEHOLL, CHRIS J (PHARMD, BCNP)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:J
Last Name:DEHOLL
Suffix:
Gender:M
Credentials:PHARMD, BCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 GOLDFINCH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9099
Mailing Address - Country:US
Mailing Address - Phone:828-505-6019
Mailing Address - Fax:
Practice Address - Street 1:409 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2643
Practice Address - Country:US
Practice Address - Phone:336-993-2195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-03
Last Update Date:2016-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20203183500000X
SC010746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist