Provider Demographics
NPI:1619962073
Name:HOLLAND, ROBERT RAYMOND (DC LMT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RAYMOND
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:DC LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 KALAKAUA AVE
Mailing Address - Street 2:#3204
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3766
Mailing Address - Country:US
Mailing Address - Phone:808-671-5556
Mailing Address - Fax:
Practice Address - Street 1:1750 KALAKAUA AVE
Practice Address - Street 2:#3204
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-3766
Practice Address - Country:US
Practice Address - Phone:808-671-5556
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor