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General NPI Number Information
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NPI Number | 1568140895
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Entity Type | Organization
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Legal Business Name | ECLIPSE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/07/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 408 ULUNIU ST
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City | KAILUA
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State | HI
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Zip | 96734-2517
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Country | US
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Telephone | 808-777-9975
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Fax | 808-215-8006
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Provider Business Mailing Address
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Address Line | 44-313 KANEOHE BAY DR APT B
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City | KANEOHE
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State | HI
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Zip | 96744-2608
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Country | US
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Telephone | 816-645-4994
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Fax |
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Authorized Official
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Title or Position | OWNER/ CHIROPRACTOR
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Name | DR. NICHOLAS ANTHONY LATONA
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Credential | DC
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Telephone | 808-777-9975
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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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