Healthcare Provider Details

I. General information

NPI: 1588036388
Provider Name (Legal Business Name): ERIC VROOM D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 CENTER ST STE 201
HONOLULU HI
96816-3209
US

IV. Provider business mailing address

3376 LOULU ST APT A
HONOLULU HI
96822-1283
US

V. Phone/Fax

Practice location:
  • Phone: 808-975-9000
  • Fax:
Mailing address:
  • Phone: 808-476-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-1244
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: