Provider Demographics
NPI:1568600310
Name:HOLDER, CHRISTOPHER JOHN (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:HOLDER
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:435 PETALUMA AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4273
Mailing Address - Country:US
Mailing Address - Phone:707-861-7300
Mailing Address - Fax:707-823-8568
Practice Address - Street 1:435 PETALUMA AVE STE 150
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4273
Practice Address - Country:US
Practice Address - Phone:707-861-7300
Practice Address - Fax:707-823-8568
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA613175F00000X
WANT60041566175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath