Provider Demographics
NPI:1487714929
Name:HOLLIDAY, JAMES D (DC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:HOLLIDAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1357 REMOUNT RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-3300
Mailing Address - Country:US
Mailing Address - Phone:843-529-9709
Mailing Address - Fax:843-529-9711
Practice Address - Street 1:1357 REMOUNT RD
Practice Address - Street 2:SUITE 6
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-3300
Practice Address - Country:US
Practice Address - Phone:843-529-9709
Practice Address - Fax:843-529-9711
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2560111N00000X
NYX009894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2560Medicaid
NYX009894OtherLICENSE NUMBER
SC2560OtherLICENSE NUMBER
SC8761Medicare PIN