Provider Demographics
NPI:1396846051
Name:WELTY-MILLER, HOLLY JOLENE (DC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:JOLENE
Last Name:WELTY-MILLER
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 1:101 1ST ST NW
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301-5605
Mailing Address - Country:US
Mailing Address - Phone:540-980-1425
Mailing Address - Fax:540-980-1427
Practice Address - Street 1:101 1ST ST NW
Practice Address - Street 2:SUITE 1B
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-5605
Practice Address - Country:US
Practice Address - Phone:540-980-1425
Practice Address - Fax:540-980-1427
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor