Provider Demographics
NPI:1649550237
Name:HOLLAND, MATTHEW TYLER (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:TYLER
Last Name:HOLLAND
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 1:92 MAIN AVE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681
Mailing Address - Country:US
Mailing Address - Phone:828-352-9151
Mailing Address - Fax:828-352-9130
Practice Address - Street 1:92 MAIN AVE DRIVE
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681
Practice Address - Country:US
Practice Address - Phone:828-352-9151
Practice Address - Fax:828-352-9130
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor