Provider Demographics
NPI:1770042160
Name:GARZA WELLNESS CARE CENTER, LLC
Entity Type:Organization
Organization Name:GARZA WELLNESS CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIANOKEOLA
Authorized Official - Middle Name:ELIANA
Authorized Official - Last Name:MORA-DUQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-392-6773
Mailing Address - Street 1:1744 LILIHA ST. SUITE #201
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-533-2425
Mailing Address - Fax:
Practice Address - Street 1:1744 LILIHA ST. SUITE #201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-533-2425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861553190OtherNPI AS INDIVIDUAL