Provider Demographics
NPI:1104908136
Name:HOLTEN CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:HOLTEN CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-435-8480
Mailing Address - Street 1:7677 PARAGON RD # D1
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4068
Mailing Address - Country:US
Mailing Address - Phone:937-435-8480
Mailing Address - Fax:
Practice Address - Street 1:7677 PARAGON RD # D1
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4068
Practice Address - Country:US
Practice Address - Phone:937-435-8480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty