Provider Demographics
NPI:1326692724
Name:ION WELLNESS LLC
Entity Type:Organization
Organization Name:ION WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENORA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:CARRAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-228-9830
Mailing Address - Street 1:91-902 FORT WEAVER RD STE P204
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2261
Mailing Address - Country:US
Mailing Address - Phone:808-228-9830
Mailing Address - Fax:808-441-3105
Practice Address - Street 1:91-902 FORT WEAVER RD STE P204
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2261
Practice Address - Country:US
Practice Address - Phone:808-228-9830
Practice Address - Fax:808-441-3105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation