Provider Demographics
NPI:1932221587
Name:HOLLOWELL, CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:HOLLOWELL
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 1:557 GLOVER AVE
Mailing Address - Street 2:STE 27
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2024
Mailing Address - Country:US
Mailing Address - Phone:334-393-4425
Mailing Address - Fax:334-347-7074
Practice Address - Street 1:557 GLOVER AVE
Practice Address - Street 2:STE 27
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2024
Practice Address - Country:US
Practice Address - Phone:334-393-4425
Practice Address - Fax:334-347-7074
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU13226Medicare UPIN
AL72906Medicare ID - Type Unspecified