Provider Demographics
NPI:1992824577
Name:HOLT, DANIEL W (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:HOLT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8391 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8065
Mailing Address - Country:US
Mailing Address - Phone:907-790-4422
Mailing Address - Fax:907-790-4423
Practice Address - Street 1:8391 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8065
Practice Address - Country:US
Practice Address - Phone:907-790-4422
Practice Address - Fax:907-790-4423
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKU66690Medicare UPIN
AKK150065Medicare ID - Type Unspecified