Provider Demographics
NPI:1407144223
Name:HOLLSTROM, CHERI RENEE (BS,MT ASCP, DC)
Entity Type:Individual
Prefix:DR
First Name:CHERI
Middle Name:RENEE
Last Name:HOLLSTROM
Suffix:
Gender:F
Credentials:BS,MT ASCP, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3889 W 103RD DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2453
Mailing Address - Country:US
Mailing Address - Phone:720-308-1138
Mailing Address - Fax:303-265-9477
Practice Address - Street 1:3889 W 103RD DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-2453
Practice Address - Country:US
Practice Address - Phone:720-308-1138
Practice Address - Fax:303-265-9477
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1609111N00000X, 111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
No111N00000XChiropractic ProvidersChiropractor