Provider Demographics
NPI:1710131974
Name:CLEAR CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CLEAR CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:CLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-315-0965
Mailing Address - Street 1:PO BOX 492612
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-2612
Mailing Address - Country:US
Mailing Address - Phone:808-315-0965
Mailing Address - Fax:
Practice Address - Street 1:16-576 KEAAU PAHOA RD
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-8105
Practice Address - Country:US
Practice Address - Phone:808-315-0965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1103111N00000X
HI1104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty