Provider Demographics
NPI:1275708430
Name:HOLDGRAFER, RODNEY MICHAEL (DC,)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:MICHAEL
Last Name:HOLDGRAFER
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 1:6545 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-2918
Mailing Address - Country:US
Mailing Address - Phone:215-821-2715
Mailing Address - Fax:215-437-7065
Practice Address - Street 1:6545 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-2918
Practice Address - Country:US
Practice Address - Phone:215-821-2715
Practice Address - Fax:215-437-7065
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor