Provider Demographics
NPI:1437475811
Name:HOLLAND SPRING SHOES
Entity Type:Organization
Organization Name:HOLLAND SPRING SHOES
Other - Org Name:Z-COIL PAIN RELIEF FOOTWEAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:757-961-1600
Mailing Address - Street 1:4540 PRINCESS ANNE RD
Mailing Address - Street 2:SUITE 123
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7962
Mailing Address - Country:US
Mailing Address - Phone:757-961-1600
Mailing Address - Fax:757-961-6868
Practice Address - Street 1:4540 PRINCESS ANNE RD
Practice Address - Street 2:SUITE 123
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7962
Practice Address - Country:US
Practice Address - Phone:757-961-1600
Practice Address - Fax:757-961-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-11
Last Update Date:2010-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier