Provider Demographics
NPI:1972648780
Name:HOLAS, MELISSA JANINE (DC MS, ATC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JANINE
Last Name:HOLAS
Suffix:
Gender:F
Credentials:DC MS, ATC
Other - Prefix:DR
Other - First Name:MISSY
Other - Middle Name:
Other - Last Name:HOLAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, MS, ATC
Mailing Address - Street 1:1101 AUGUSTA DR SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4448
Mailing Address - Country:US
Mailing Address - Phone:770-517-2240
Mailing Address - Fax:770-517-2286
Practice Address - Street 1:215 PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1723
Practice Address - Country:US
Practice Address - Phone:404-389-0931
Practice Address - Fax:404-389-0932
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007519111N00000X
GACHIR007519111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor