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General NPI Number Information
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NPI Number | 1265102693
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Entity Type | Organization
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Legal Business Name | MALAMA CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 5-4280 KUHIO HWY # B-206
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City | PRINCEVILLE
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State | HI
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Zip | 96722-5451
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Country | US
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Telephone | 808-634-2159
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Fax | 808-826-7600
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Provider Business Mailing Address
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Address Line | 4163 WAIPUA ST
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City | KILAUEA
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State | HI
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Zip | 96754-5334
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Country | US
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Telephone | 808-634-2159
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KALANI STANLEY WALTHER
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Credential | DC
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Telephone | 808-634-2159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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