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NPI Code Detail

MEDICARE: DR. JESSE CRACKNELL D.C,

MEDICARE: DR. JESSE CRACKNELL D.C,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC-945HI

General Provider Information

NPI Number : 1780887141
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSE CRACKNELL D.C,
Provider Business Mailing Address
First Line : 3427 WAIALAE AVE # 335
Second Line :
City : HONOLULU
State : HI
Zip : 96816-2619
Country : US
Telephone Number : 808-737-4325
Fax Number : 808-737-4324
Provider Business Practice Location Address
First Line : 3615 HARDING AVE STE 202
Second Line :
City : HONOLULU
State : HI
Zip : 96816-3760
Country : US
Telephone Number : 808-737-4325
Fax Number : 808-737-4324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2007
Last Update Date : 04/01/2022

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Directions to “ DR. JESSE CRACKNELL D.C,” Practice Location

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