Healthcare Provider Details

I. General information

NPI: 1801964390
Provider Name (Legal Business Name): VALLEY ISLE CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 HANA HWY #213
KAHULUI HI
96732-2315
US

IV. Provider business mailing address

444 HANA HWY #213
KAHULUI HI
96732-2315
US

V. Phone/Fax

Practice location:
  • Phone: 808-877-5587
  • Fax: 808-871-8024
Mailing address:
  • Phone: 808-877-5587
  • Fax: 808-871-8024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. SUNI M CONNELLY
Title or Position: PRESIDENT
Credential: DC
Phone: 808-877-5587