Provider Demographics
NPI:1720072820
Name:HOLEN, KAREN ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELIZABETH
Last Name:HOLEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:ELIZABETH
Other - Last Name:BARCLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MI
Mailing Address - Zip Code:49236-0616
Mailing Address - Country:US
Mailing Address - Phone:517-456-7411
Mailing Address - Fax:
Practice Address - Street 1:301 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MI
Practice Address - Zip Code:49236-9502
Practice Address - Country:US
Practice Address - Phone:517-456-7411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8654DC111NR0400X
OH4285111NR0400X
WACH-60806257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAN335OtherCARE FIRST
PA001359906OtherBLUE SHIELD
OH1720072820Medicaid
PA2014734OtherFIRST HEALTH
PA7584446OtherAETNA
PAF895KEOtherCARE FIRST