Provider Demographics
NPI:1396032967
Name:HOLLAND, MARY DARLENE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:DARLENE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7327 TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2318
Mailing Address - Country:US
Mailing Address - Phone:434-237-0413
Mailing Address - Fax:
Practice Address - Street 1:7327 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2318
Practice Address - Country:US
Practice Address - Phone:434-237-0413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor