Provider Demographics
NPI:1235711474
Name:AVAIL SOFT TISSUE AND SPINE, LLC
Entity Type:Organization
Organization Name:AVAIL SOFT TISSUE AND SPINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-909-7142
Mailing Address - Street 1:PO BOX 1316
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81658-1316
Mailing Address - Country:US
Mailing Address - Phone:303-909-7142
Mailing Address - Fax:
Practice Address - Street 1:77 GAMBEL ST # B
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-5957
Practice Address - Country:US
Practice Address - Phone:970-328-2884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty