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General NPI Number Information
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NPI Number | 1669745816
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Entity Type | Organization
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Legal Business Name | KEY TO LIFE CHIROPRACTIC INC
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Dates
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Enumeration Date | 02/20/2012
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Last Update Date | 02/20/2012
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Provider Practice Location Address
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Address Line | 5095 NAPILIHAU ST STE 205
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City | LAHAINA
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State | HI
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Zip | 96761-8800
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Country | US
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Telephone | 808-669-4035
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Fax | 808-669-0740
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Provider Business Mailing Address
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Address Line | 5095 NAPILIHAU ST STE 205
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City | LAHAINA
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State | HI
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Zip | 96761-8800
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Country | US
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Telephone | 808-669-4035
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Fax | 808-669-0740
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | BERNADETTE OWENS
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Credential |
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Telephone | 808-669-4035
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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 | 504
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License Number State | HI
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