Provider Demographics
NPI:1235733882
Name:HOLT, LUKE JAMES (DC)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:JAMES
Last Name:HOLT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 22ND AVE S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-2600
Mailing Address - Country:US
Mailing Address - Phone:605-692-2251
Mailing Address - Fax:605-692-2255
Practice Address - Street 1:116 22ND AVE S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2600
Practice Address - Country:US
Practice Address - Phone:605-692-2251
Practice Address - Fax:605-692-2255
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor