Healthcare Provider Details

I. General information

NPI: 1700436805
Provider Name (Legal Business Name): HONOLULU ELITE CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD STE 808
HONOLULU HI
96814-4404
US

IV. Provider business mailing address

725A 8TH AVE
HONOLULU HI
96816-7102
US

V. Phone/Fax

Practice location:
  • Phone: 808-647-4500
  • Fax:
Mailing address:
  • Phone: 808-647-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. AARIES T ODA
Title or Position: MANAGER
Credential: DC
Phone: 808-647-4500