Provider Demographics
NPI:1497851521
Name:HOLLIS, DAVID AARON (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:AARON
Last Name:HOLLIS
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 217
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-0217
Mailing Address - Country:US
Mailing Address - Phone:913-367-3963
Mailing Address - Fax:913-367-7495
Practice Address - Street 1:940 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-2327
Practice Address - Country:US
Practice Address - Phone:913-367-3963
Practice Address - Fax:913-367-7495
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU52763Medicare UPIN
KS060068Medicare ID - Type Unspecified