Healthcare Provider Details

I. General information

NPI: 1326692724
Provider Name (Legal Business Name): ION WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-902 FORT WEAVER RD STE P204
EWA BEACH HI
96706-2261
US

IV. Provider business mailing address

91-902 FORT WEAVER RD STE P204
EWA BEACH HI
96706-2261
US

V. Phone/Fax

Practice location:
  • Phone: 808-228-9830
  • Fax: 808-441-3105
Mailing address:
  • Phone: 808-228-9830
  • Fax: 808-441-3105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LENORA KATHLEEN CARRAS
Title or Position: OWNER
Credential: LMT
Phone: 808-228-9830