Provider Demographics
NPI:1295994101
Name:HOLLIS, COREY ARTHUR (DC)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:ARTHUR
Last Name:HOLLIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:17911 SKY PARK CIR
Mailing Address - Street 2:SUITE L
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6322
Mailing Address - Country:US
Mailing Address - Phone:949-502-5520
Mailing Address - Fax:949-502-5593
Practice Address - Street 1:17911 SKY PARK CIR
Practice Address - Street 2:SUITE L
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6322
Practice Address - Country:US
Practice Address - Phone:949-502-5520
Practice Address - Fax:949-502-5593
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA28089111NR0400X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0800XChiropractic ProvidersChiropractorOrthopedic