Provider Demographics
NPI:1871733964
Name:GUIDRY, HOLLY R (DC)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:R
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17502 HIGHWAY 171
Mailing Address - Street 2:
Mailing Address - City:RAGLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70657-7122
Mailing Address - Country:US
Mailing Address - Phone:337-275-0421
Mailing Address - Fax:
Practice Address - Street 1:1606 N PINE ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-2420
Practice Address - Country:US
Practice Address - Phone:337-462-3055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor