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General NPI Number Information
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NPI Number | 1710131974
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Entity Type | Organization
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Legal Business Name | CLEAR CHIROPRACTIC LLC
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 16-576 KEAAU PAHOA RD
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City | KEAAU
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State | HI
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Zip | 96749-8105
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Country | US
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Telephone | 808-315-0965
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 492612
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City | KEAAU
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State | HI
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Zip | 96749-2612
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Country | US
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Telephone | 808-315-0965
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES PATRICK CLEAR
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Credential | D.C.
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Telephone | 808-315-0965
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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 | 1104
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1103
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License Number State | HI
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