Provider Demographics
NPI:1083714869
Name:HOLEWINSKI, KENNETH G (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:G
Last Name:HOLEWINSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 SIMPSON ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314
Mailing Address - Country:US
Mailing Address - Phone:404-525-3772
Mailing Address - Fax:404-525-3773
Practice Address - Street 1:755 SIMPSON ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314
Practice Address - Country:US
Practice Address - Phone:404-525-3772
Practice Address - Fax:404-525-3773
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2306111N00000X
AL1667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50012988OtherRAIL ROAD MEDICARE
GA50012988OtherRAIL ROAD MEDICARE