Healthcare Provider Details

I. General information

NPI: 1962315374
Provider Name (Legal Business Name): ISLAND SPINE AND HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2153 N KING ST STE 302A
HONOLULU HI
96819-4560
US

IV. Provider business mailing address

95-1045 KENI ST
MILILANI HI
96789-6550
US

V. Phone/Fax

Practice location:
  • Phone: 401-423-5752
  • Fax:
Mailing address:
  • Phone: 808-489-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JARED QUITOLES
Title or Position: MANAGER
Credential: DC
Phone: 808-489-0242