Provider Demographics
NPI:1184705055
Name:HOLICK, ROBERT J (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:HOLICK
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 1:102 OGLETHORPE PROFESSIONAL COURT
Mailing Address - Street 2:SUITE #6
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406
Mailing Address - Country:US
Mailing Address - Phone:912-352-8051
Mailing Address - Fax:912-352-8076
Practice Address - Street 1:102 OGLETHORPE PROFESSIONAL COURT
Practice Address - Street 2:SUITE #6
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406
Practice Address - Country:US
Practice Address - Phone:912-352-8051
Practice Address - Fax:912-352-8076
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
352CCGJMedicare ID - Type Unspecified
U41705Medicare UPIN