Provider Demographics
NPI:1225495666
Name:HOLL ENTERPRISES, LLC
Entity Type:Organization
Organization Name:HOLL ENTERPRISES, LLC
Other - Org Name:COMPLETE BALANCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-980-5148
Mailing Address - Street 1:7320 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:RALSTON
Mailing Address - State:NE
Mailing Address - Zip Code:68128-1734
Mailing Address - Country:US
Mailing Address - Phone:402-980-5148
Mailing Address - Fax:
Practice Address - Street 1:7320 HARRISON ST
Practice Address - Street 2:
Practice Address - City:RALSTON
Practice Address - State:NE
Practice Address - Zip Code:68128-1734
Practice Address - Country:US
Practice Address - Phone:402-980-5148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1220111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEDN2800OtherRAILROAD MEDICARE
NE10026617800Medicaid
NE272978-001Medicare PIN