Healthcare Provider Details

I. General information

NPI: 1568471928
Provider Name (Legal Business Name): GREGORY EUGENE HUNGERFORD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66-560 KAMEHAMEHA HWY STE . 5
HALEIWA HI
96712-1405
US

IV. Provider business mailing address

66-560 KAMEHAMEHA HWY STE. 5
HALEIWA HI
96712-1405
US

V. Phone/Fax

Practice location:
  • Phone: 808-780-2601
  • Fax: 808-637-2255
Mailing address:
  • Phone: 808-780-2601
  • Fax: 808-637-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC1012
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: