Provider Demographics
NPI:1588015267
Name:HOLDA, JOSHUA RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:RICHARD
Last Name:HOLDA
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 1:307 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FLORA
Mailing Address - State:IN
Mailing Address - Zip Code:46929-1046
Mailing Address - Country:US
Mailing Address - Phone:765-202-1693
Mailing Address - Fax:574-371-2727
Practice Address - Street 1:118 W MARKET ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-2812
Practice Address - Country:US
Practice Address - Phone:574-268-2727
Practice Address - Fax:574-371-2727
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002913A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor