Doctor Name: | DR. JACK K HOLLEY |
NPI Number: | 1023013521 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | 038-006027 |
Business Practice Address: | 654 W Veterans Pkwy Suite B Yorkville, IL - 605604567 |
Business Phone Number: | 6305531876 |
Business Fax Number: | 6305665180 |
Mailing Address: | 654 W Veterans Pkwy, Suite B YORKVILLE |
State: | IL |
Postal Code: | 605604567 |
Phone Number: | 6305531876 |
Fax Number: | 6305665180 |
NPI Enumeration Date: | 06/20/2005 |
NPI Last Update Date: | 09/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 038-006027 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |