Provider Demographics
NPI:1497493969
Name:ARMED FORCES CHIROPRACTIC
Entity Type:Organization
Organization Name:ARMED FORCES CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:DERTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-343-0824
Mailing Address - Street 1:133 JEAL RD
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-5811
Mailing Address - Country:US
Mailing Address - Phone:808-343-0824
Mailing Address - Fax:
Practice Address - Street 1:133 JEAL RD
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-5811
Practice Address - Country:US
Practice Address - Phone:808-343-0824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty