Provider Demographics
NPI:1588824486
Name:SMITH, HOLLY ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32119-1401
Mailing Address - Country:US
Mailing Address - Phone:386-492-5932
Mailing Address - Fax:
Practice Address - Street 1:1180 W GRANADA BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8165
Practice Address - Country:US
Practice Address - Phone:386-492-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor