Provider Demographics
NPI:1104107978
Name:BIRHANZEL, HOLLY AMBER (DC)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:AMBER
Last Name:BIRHANZEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:HOLLY
Other - Middle Name:AMBER
Other - Last Name:DOLLERSCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3165 FERNBROOK LANE N.
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447
Mailing Address - Country:US
Mailing Address - Phone:763-710-4636
Mailing Address - Fax:763-710-4473
Practice Address - Street 1:3165 FERNBROOK LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5320
Practice Address - Country:US
Practice Address - Phone:763-710-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5124111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor