Provider Demographics
NPI:1255584785
Name:MELODY A. HOLLADAY, D.C., PLLC
Entity type:Organization
Organization Name:MELODY A. HOLLADAY, D.C., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLLADAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-203-9060
Mailing Address - Street 1:70 N PAYNE PL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-4536
Mailing Address - Country:US
Mailing Address - Phone:928-203-9060
Mailing Address - Fax:928-204-0039
Practice Address - Street 1:70 N PAYNE PL
Practice Address - Street 2:SUITE 1
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4536
Practice Address - Country:US
Practice Address - Phone:928-203-9060
Practice Address - Fax:928-204-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5883111NI0900X, 111NN0400X, 111NN1001X, 111NR0200X, 111NS0005X, 111NT0100X, 111NX0100X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
No111NT0100XChiropractic ProvidersChiropractorThermographyGroup - Single Specialty
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty