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General NPI Number Information
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NPI Number | 1619356870
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Entity Type | Organization
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Legal Business Name | PONO CHIROPRACTIC INSTITUTE CORPORATION
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | 4800 KAWAIHAU RD
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City | KAPAA
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State | HI
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Zip | 96746-1971
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Country | US
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Telephone | 808-353-1114
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | ANAHOLA
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State | HI
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Zip | 96703-0640
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Country | US
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Telephone | 808-353-1114
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HARI SIMRAN SINGH KHALSA
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Credential | D.C.
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Telephone | 808-353-1114
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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 | 1227
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License Number State | HI
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