Individual
DR. JACK DEE HOLLADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
200 E BEARDSTOWN ST, VIRGINIA, IL 62691-1304
(217) 452-7252
Mailing address
200 E BEARDSTOWN ST, VIRGINIA, IL 62691-1304
(217) 452-7252
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-004567
IL
111N00000X
Chiropractor
CH4004
FL
Other
Enumeration date
07/20/2005
Last updated
07/08/2007
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