Provider Demographics
NPI:1689850539
Name:HOLLOWAY, DOREEN MADELEINE DAY
Entity Type:Individual
Prefix:MRS
First Name:DOREEN
Middle Name:MADELEINE DAY
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DOREEN
Other - Middle Name:MADELEINE
Other - Last Name:DAY HOLLOWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1064 MEADOWVIEW DR
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4821
Mailing Address - Country:US
Mailing Address - Phone:828-265-8300
Mailing Address - Fax:336-667-8718
Practice Address - Street 1:1064 MEADOWVIEW DR STE 8
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4855
Practice Address - Country:US
Practice Address - Phone:828-265-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3195111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor