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General NPI Number Information
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NPI Number | 1346386851
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Entity Type | Individual
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Provider Name | DOUGLAS DAVID BERRY JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 1280 S KIHEI RD APT 121
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City | KIHEI
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State | HI
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Zip | 96753-5296
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Country | US
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Telephone | 808-727-2121
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Fax | 87-272-2118
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Provider Business Mailing Address
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Address Line | 305 IINI WAY
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City | MAKAWAO
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State | HI
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Zip | 96768-7906
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Country | US
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Telephone | 253-209-9725
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Fax | 808-727-2211
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC1577
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License Number State | HI
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