Provider Demographics
NPI:1023374253
Name:HALEOLA CHIROPRACTIC INC
Entity Type:Organization
Organization Name:HALEOLA CHIROPRACTIC INC
Other - Org Name:PALOMA CHIROPRACTIC AND MASSAGE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALOMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-477-8222
Mailing Address - Street 1:2100 NE BROADWAY ST
Mailing Address - Street 2:SUITE 125
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1569
Mailing Address - Country:US
Mailing Address - Phone:503-477-8222
Mailing Address - Fax:971-373-8648
Practice Address - Street 1:2100 NE BROADWAY ST
Practice Address - Street 2:SUITE 125
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1569
Practice Address - Country:US
Practice Address - Phone:503-477-8222
Practice Address - Fax:971-373-8648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty