Provider Demographics
NPI:1114106424
Name:HOLDER CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:HOLDER CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-848-2236
Mailing Address - Street 1:317 CARLISLE AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-3203
Mailing Address - Country:US
Mailing Address - Phone:717-848-2236
Mailing Address - Fax:717-848-2236
Practice Address - Street 1:317 CARLISLE AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-3203
Practice Address - Country:US
Practice Address - Phone:717-848-2236
Practice Address - Fax:717-848-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007064-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA036380OtherBC/BS
PA036380OtherBC/BS