Provider Demographics
NPI:1679783732
Name:HOLM, DANA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:HOLM
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 1:2701 S. MINNESOTA AVE.
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-4746
Mailing Address - Country:US
Mailing Address - Phone:404-271-9527
Mailing Address - Fax:
Practice Address - Street 1:2701 S. MINNESOTA AVE.
Practice Address - Street 2:SUITE 3
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-4746
Practice Address - Country:US
Practice Address - Phone:404-271-9527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7605060Medicaid
GAV05411Medicare UPIN
SD7605060Medicaid