1710919121 NPI number — GUTHRIE FAMILY CHIROPRACTIC

Table of content: (NPI 1710919121)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710919121 NPI number — GUTHRIE FAMILY CHIROPRACTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GUTHRIE FAMILY CHIROPRACTIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710919121
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45-1144 KAMEHAMEHA HWY
Provider Second Line Business Mailing Address:
SUITE 200 D
Provider Business Mailing Address City Name:
KANEOHE
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96744-3244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-235-5113
Provider Business Mailing Address Fax Number:
808-235-8372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45-1144 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
SUITE 200 D
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744-3244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-235-5113
Provider Business Practice Location Address Fax Number:
808-235-8372
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GUTHRIE
Authorized Official First Name:
SHAYNE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CHIROPRACTOR/OWNER
Authorized Official Telephone Number:
808-235-5113

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  805 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: H52246 . This is a "GROUP BOX 33" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com