Provider Demographics
NPI:1447658646
Name:HOLUSZKO, JEFFREY (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:HOLUSZKO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 JOHN STARK HWY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773-2120
Mailing Address - Country:US
Mailing Address - Phone:810-874-6727
Mailing Address - Fax:
Practice Address - Street 1:104 JOHN STARK HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-2120
Practice Address - Country:US
Practice Address - Phone:810-874-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-21
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor