Healthcare Provider Details

I. General information

NPI: 1922871540
Provider Name (Legal Business Name): DRISTIN MYERS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 SALT LAKE BLVD STE B6
HONOLULU HI
96818-3171
US

IV. Provider business mailing address

99-080 KAUHALE ST STE D9
AIEA HI
96701-4114
US

V. Phone/Fax

Practice location:
  • Phone: 808-321-7135
  • Fax: 808-200-3607
Mailing address:
  • Phone: 808-637-2608
  • Fax: 808-748-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1629
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15891
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: