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General NPI Number Information
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NPI Number | 1538724018
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Entity Type | Individual
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Provider Name | SCOTT DEANE
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Gender | Male
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 91-902 FORT WEAVER RD STE 204
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City | EWA BEACH
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State | HI
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Zip | 96706-2261
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Country | US
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Telephone | 808-517-4826
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Fax |
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Provider Business Mailing Address
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Address Line | 91-530 MAKALEA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-5941
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Country | US
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Telephone | 323-767-4613
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Fax |
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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 | 1418
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License Number State | HI
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