Provider Demographics
NPI:1982972196
Name:HOLMES, DONALD CAMERON JR
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:CAMERON
Last Name:HOLMES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:501 W SIERRA AVE
Mailing Address - Street 2:# 239
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1137
Mailing Address - Country:US
Mailing Address - Phone:559-930-9051
Mailing Address - Fax:
Practice Address - Street 1:501 W SIERRA AVE
Practice Address - Street 2:# 239
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1137
Practice Address - Country:US
Practice Address - Phone:559-930-9051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14399111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health