Provider Demographics
NPI:1407990401
Name:HOLLIDAY, RUTH HEATHER (DC)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:HEATHER
Last Name:HOLLIDAY
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 1:2902 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-5024
Mailing Address - Country:US
Mailing Address - Phone:804-398-0288
Mailing Address - Fax:
Practice Address - Street 1:12426 GAYTON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-2269
Practice Address - Country:US
Practice Address - Phone:804-741-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor