Provider Demographics
NPI:1619193703
Name:JILL L. DAWRS, D.C., INC.
Entity Type:Organization
Organization Name:JILL L. DAWRS, D.C., INC.
Other - Org Name:DR. JILL DAWRS FAMILY CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:DAWRS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-935-0004
Mailing Address - Street 1:198 PONAHAWAI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3027
Mailing Address - Country:US
Mailing Address - Phone:808-935-0004
Mailing Address - Fax:808-961-5439
Practice Address - Street 1:198 PONAHAWAI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3027
Practice Address - Country:US
Practice Address - Phone:808-935-0004
Practice Address - Fax:808-961-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52194Medicare ID - Type UnspecifiedLEGACY PROVIDER NUMBER
HI52193Medicare ID - Type UnspecifiedLEGACY GROUP NUMBER