Healthcare Provider Details

I. General information

NPI: 1578797320
Provider Name (Legal Business Name): BRAD K LEE DC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 KAPIOLANI BLVD STE C306
HONOLULU HI
96813-6014
US

IV. Provider business mailing address

725 KAPIOLANI BLVD STE C306
HONOLULU HI
96813-6014
US

V. Phone/Fax

Practice location:
  • Phone: 808-596-8090
  • Fax: 808-596-2312
Mailing address:
  • Phone: 808-596-8090
  • Fax: 808-596-2312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JOANNE LEE
Title or Position: MANAGER
Credential:
Phone: 808-596-8090