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General NPI Number Information
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NPI Number | 1295915783
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Entity Type | Organization
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Legal Business Name | WELLIFE CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 4510 SALT LAKE BLVD STE B5
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City | HONOLULU
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State | HI
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Zip | 96818-3171
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Country | US
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Telephone | 808-487-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 4510 SALT LAKE BLVD STE B5
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City | HONOLULU
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State | HI
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Zip | 96818-3171
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Country | US
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Telephone | 808-487-7900
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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. STEVEN RAWSON
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Credential | D.C.
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Telephone | 808-487-7900
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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 | DC903
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License Number State | HI
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