Provider Demographics
NPI:1497298467
Name:HOLEN, ADAM BERNARD (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:BERNARD
Last Name:HOLEN
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:PO BOX 1316
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81658-1316
Mailing Address - Country:US
Mailing Address - Phone:303-909-7142
Mailing Address - Fax:
Practice Address - Street 1:77 GAMBEL ST # B
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-5957
Practice Address - Country:US
Practice Address - Phone:970-328-2884
Practice Address - Fax:970-328-2884
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-23
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0007314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor