Provider Demographics
NPI:1568140895
Name:ECLIPSE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ECLIPSE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LATONA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-777-9975
Mailing Address - Street 1:44-313 KANEOHE BAY DR APT B
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2608
Mailing Address - Country:US
Mailing Address - Phone:816-645-4994
Mailing Address - Fax:
Practice Address - Street 1:408 ULUNIU ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2517
Practice Address - Country:US
Practice Address - Phone:808-777-9975
Practice Address - Fax:808-215-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty