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NPI 1598817769

NPI 1598817769 : DEBORAH S. I. GLENN D.C. : KAILUA, HI

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General NPI Number Information
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    NPI Number           |    1598817769
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    Entity Type          |    Individual 
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    Provider Name        |    DEBORAH S. I. GLENN D.C.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/17/2007
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    Last Update Date     |    03/03/2021
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Provider Practice Location Address
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    Address Line         |    415 ULUNIU ST STE D 
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    City                 |    KAILUA
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    State                |    HI
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    Zip                  |    96734-2503
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    Country              |    US
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    Telephone            |    808-262-2099
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1768 
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    City                 |    KAILUA
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    State                |    HI
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    Zip                  |    96734-8768
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    Country              |    US
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    Telephone            |    808-262-2099
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    Fax                  |    808-263-9720
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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       |    907
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    License Number State |    HI
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