Provider Demographics
NPI:1174708143
Name:HOLDEN, ELTON DARRELL (DC)
Entity type:Individual
Prefix:DR
First Name:ELTON
Middle Name:DARRELL
Last Name:HOLDEN
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 1:3155 ROSWELL RD NE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1821
Mailing Address - Country:US
Mailing Address - Phone:404-455-4804
Mailing Address - Fax:404-231-5546
Practice Address - Street 1:3155 ROSWELL RD NE
Practice Address - Street 2:SUITE 140
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1821
Practice Address - Country:US
Practice Address - Phone:404-455-4804
Practice Address - Fax:404-231-5546
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor