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General NPI Number Information
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NPI Number | 1568896546
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Entity Type | Organization
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Legal Business Name | FAMILY AND SPORTS CHIROPRACTIC CENTER INC
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 94-1060 ANANIA CIR APT 114
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City | MILILANI
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State | HI
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Zip | 96789-2041
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Country | US
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Telephone | 808-497-1729
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Fax |
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Provider Business Mailing Address
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Address Line | 94-1060 ANANIA CIR APT 114
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City | MILILANI
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State | HI
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Zip | 96789-2041
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Country | US
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Telephone | 808-497-1729
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAUN OHIRA
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Credential | DC
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Telephone | 808-497-1729
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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 | DC-1225
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License Number State | HI
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