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General NPI Number Information
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NPI Number | 1245565613
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Entity Type | Organization
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Legal Business Name | KAILUA WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 10/02/2009
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 228 KUULEI RD
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City | KAILUA
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State | HI
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Zip | 96734-2720
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Country | US
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Telephone | 808-261-8181
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Fax | 808-261-7770
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Provider Business Mailing Address
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Address Line | 228 KUULEI RD
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City | KAILUA
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State | HI
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Zip | 96734-2720
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Country | US
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Telephone | 808-261-8181
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Fax | 808-261-7770
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Authorized Official
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Title or Position | OWNER
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Name | DR. TYLER D RYAN
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Credential | DC
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Telephone | 808-261-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 404
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License Number State | HI
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