Provider Demographics
NPI:1841354842
Name:BARROW, HOLIDAE ELAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:HOLIDAE
Middle Name:ELAYNE
Last Name:BARROW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 COURT ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3112
Mailing Address - Country:US
Mailing Address - Phone:530-666-6685
Mailing Address - Fax:530-666-6676
Practice Address - Street 1:113 COURT ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3112
Practice Address - Country:US
Practice Address - Phone:530-666-6685
Practice Address - Fax:530-666-6676
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU97434Medicare UPIN
CADC0286250Medicare ID - Type UnspecifiedMEDICARE PPIN
CAZZZ27262ZMedicare ID - Type UnspecifiedGROUP ID