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General NPI Number Information
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NPI Number | 1407446495
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Entity Type | Organization
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Legal Business Name | OAHU WELLNESS CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/22/2021
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 50 S BERETANIA ST STE C111
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City | HONOLULU
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State | HI
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Zip | 96813-2287
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Country | US
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Telephone | 808-349-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 96-212 WAIAWA RD APT 101
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City | PEARL CITY
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State | HI
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Zip | 96782-3382
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Country | US
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Telephone | 808-349-2255
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | NICHOLAS E.A. CHANG
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Credential | DC
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Telephone | 808-349-2255
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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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