Provider Demographics
NPI:1164576120
Name:BRIAN T. HOLMES, D. C. , A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:BRIAN T. HOLMES, D. C. , A CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-460-6511
Mailing Address - Street 1:2434 FLETCHER PKWY
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-2105
Mailing Address - Country:US
Mailing Address - Phone:619-460-6511
Mailing Address - Fax:619-460-6513
Practice Address - Street 1:2434 FLETCHER PKWY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2105
Practice Address - Country:US
Practice Address - Phone:619-460-6511
Practice Address - Fax:619-460-6513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty