Healthcare Provider Details

I. General information

NPI: 1407093750
Provider Name (Legal Business Name): KARL O. HYNES SR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 LANAI AVE. SUITE 112
LANAI CITY HI
96763
US

IV. Provider business mailing address

PO BOX 630604
LANAI CITY HI
96763-0604
US

V. Phone/Fax

Practice location:
  • Phone: 808-563-9632
  • Fax:
Mailing address:
  • Phone: 808-656-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number294
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: