Provider Demographics
NPI:1164744710
Name:HOLISTIC HEALTHCARE IN ALBANY, LLC
Entity Type:Organization
Organization Name:HOLISTIC HEALTHCARE IN ALBANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:229-888-1005
Mailing Address - Street 1:1144 DAWSON RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3872
Mailing Address - Country:US
Mailing Address - Phone:229-888-1005
Mailing Address - Fax:229-888-8375
Practice Address - Street 1:1144 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3872
Practice Address - Country:US
Practice Address - Phone:229-888-1005
Practice Address - Fax:229-888-8375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3106261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center