Healthcare Provider Details
I. General information
NPI: 1972938454
Provider Name (Legal Business Name): HEALTHY OPTIONS 4-U, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/04/2013
Last Update Date: 09/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
407 ULUNIU ST STE. #412
KAILUA HI
96734-2519
US
IV. Provider business mailing address
1490 HUMUWILI PL
KAILUA HI
96734-3714
US
V. Phone/Fax
- Phone: 808-222-8199
- Fax:
- Phone: 808-222-8199
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | 685 |
| License Number State | HI |
VIII. Authorized Official
Name: DR.
GLORIA
K
HAMADA
Title or Position: OWNER/MEMBER
Credential: DC
Phone: 808-222-8199