Individual
HOLLY ELIZEBETH YORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
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
01/07/2008
Last updated
12/23/2014
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