Provider Demographics
NPI:1013082650
Name:HOLMES CHIROPRACTIC PSC
Entity Type:Organization
Organization Name:HOLMES CHIROPRACTIC PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:606-326-1132
Mailing Address - Street 1:3401 SOLUTIONS CENTER LOCKBOX #773401
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-3004
Mailing Address - Country:US
Mailing Address - Phone:606-831-4432
Mailing Address - Fax:606-326-0114
Practice Address - Street 1:455 ARMCO RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7370
Practice Address - Country:US
Practice Address - Phone:606-831-4432
Practice Address - Fax:606-326-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100113950Medicaid