Provider Demographics
NPI:1619546983
Name:BOCHOW, HOLLY CLARA (BUSINESS MANAGER)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:CLARA
Last Name:BOCHOW
Suffix:
Gender:F
Credentials:BUSINESS MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 MAIN ST N
Mailing Address - Street 2:
Mailing Address - City:PIERZ
Mailing Address - State:MN
Mailing Address - Zip Code:56364-1583
Mailing Address - Country:US
Mailing Address - Phone:320-468-2221
Mailing Address - Fax:320-468-7117
Practice Address - Street 1:232 MAIN ST N
Practice Address - Street 2:
Practice Address - City:PIERZ
Practice Address - State:MN
Practice Address - Zip Code:56364-1583
Practice Address - Country:US
Practice Address - Phone:320-468-2221
Practice Address - Fax:320-468-7117
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2959111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner