Holliday, Chanelle R
Holliday, Chanelle R is an individual health care provider with primary practice located at 126 S 2Nd St , Black River Falls WI 54615-1726. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Holliday, Chanelle R can be contacted via phone (715) 284-2915.Contact Information
Primary practice address
126 S 2Nd St
Black River Falls WI 54615-1726
Phone: (715) 284-2915
Fax: (715) 284-7492
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 3715 | Wisconsin |
Profile Details
| NPI number | 1629078902 |
|---|---|
| LBN Legal business name | Holliday, Chanelle R |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629078902 | NPPES |
| Wisconsin | Other | 205747937017 | BCBS |
| Wisconsin | MEDICAID | 38929100 | BCBS |
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