Provider Demographics
NPI:1407937113
Name:HOLTZ, JEFFREY A (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:HOLTZ
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 1:123 YORK ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-3113
Mailing Address - Country:US
Mailing Address - Phone:717-633-1945
Mailing Address - Fax:717-633-1655
Practice Address - Street 1:123 YORK ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-3113
Practice Address - Country:US
Practice Address - Phone:717-633-1945
Practice Address - Fax:717-633-1655
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009971111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician