Individual
GREGORY LEE HOLMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
8620 E 32ND CT N, WICHITA, KS 67226-4007
(316) 612-0600
(316) 612-1140
Mailing address
4709 EAGLES LANDING ST, WICHITA, KS 67220-5506
(316) 734-9049
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104872
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062055
BLUE CROSS BLUE SHIELD
KS
01
—
P00229176
MEDICARE RAILRD.
KS
Enumeration date
07/07/2006
Last updated
07/08/2007
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