Provider Demographics
NPI:1639278252
Name:WALTHER, KALANI STANLEY I (DC)
Entity Type:Individual
Prefix:DR
First Name:KALANI
Middle Name:STANLEY
Last Name:WALTHER
Suffix:I
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:STANLEY
Other - Middle Name:KALANI
Other - Last Name:WALTHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:4163 WAIPUA ST
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-5334
Mailing Address - Country:US
Mailing Address - Phone:808-634-2159
Mailing Address - Fax:
Practice Address - Street 1:4163 WAIPUA ST
Practice Address - Street 2:
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754-5334
Practice Address - Country:US
Practice Address - Phone:808-634-2159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC-1180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor