Provider Demographics
NPI:1609984731
Name:HOLTZ, PATRICIA MARIE (DC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MARIE
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1157 EICHELBERGER ST STE 3
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1372
Mailing Address - Country:US
Mailing Address - Phone:717-633-1945
Mailing Address - Fax:717-633-1655
Practice Address - Street 1:1157 EICHELBERGER ST STE 3
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1372
Practice Address - Country:US
Practice Address - Phone:717-633-1945
Practice Address - Fax:717-633-1655
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109282WBNMedicare PIN
V11911Medicare UPIN