Provider Demographics
NPI:1518794700
Name:NOTHOLD SPINE AND SPORTS PLLC
Entity type:Organization
Organization Name:NOTHOLD SPINE AND SPORTS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIOPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NOTHOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-440-5635
Mailing Address - Street 1:910 BROADWAY ST STE A
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2729
Mailing Address - Country:US
Mailing Address - Phone:217-222-5800
Mailing Address - Fax:
Practice Address - Street 1:910 BROADWAY ST STE A
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2729
Practice Address - Country:US
Practice Address - Phone:217-222-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty