Provider Demographics
NPI:1235354952
Name:HOLMES CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:HOLMES CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:F
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:580-226-3555
Mailing Address - Street 1:36 TIFFANY PLAZA
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-2534
Mailing Address - Country:US
Mailing Address - Phone:580-226-3555
Mailing Address - Fax:580-226-3703
Practice Address - Street 1:36 TIFFANY PLAZA
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2534
Practice Address - Country:US
Practice Address - Phone:580-226-3555
Practice Address - Fax:580-226-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073689162OtherPERSONAL NPI
1073689162OtherPERSONAL NPI