Organization
HOLLY YORK LLC
Active
Other names
Spinal Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY ELIZEBETH YORK D.C. (OWNER/CHIROPRACTOR)
(616) 530-7474
Entity
Organization
Contact information
Practice address
3138 BROADMOOR AVE SE, KENTWOOD, MI 49512-1845
(616) 575-9105
(616) 575-9107
Mailing address
3138 BROADMOOR AVE SE, KENTWOOD, MI 49512-1845
(616) 575-9105
(616) 575-9107
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009429
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376728568
MEDICAID INDIVIDUAL ID
MI
05
—
1922191048
—
MI
Enumeration date
04/08/2011
Last updated
12/23/2014
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