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General NPI Number Information
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NPI Number | 1841471653
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Entity Type | Organization
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Legal Business Name | KAUAI CHIROPRACTIC AND WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 3092 AKAHI ST
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City | LIHUE
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State | HI
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Zip | 96766-1103
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Country | US
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Telephone | 808-246-8858
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Fax |
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Provider Business Mailing Address
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Address Line | 3092 AKAHI ST
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City | LIHUE
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State | HI
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Zip | 96766-1103
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Country | US
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Telephone | 808-246-8858
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Fax | 808-246-8805
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Authorized Official
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Title or Position | OWNER
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Name | KAIPO PAVAO
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Credential |
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Telephone | 808-246-8858
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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 | 1077
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License Number State | HI
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