Provider Demographics
NPI:1255823142
Name:DANIEL WEISBECKER DC LLC
Entity type:Organization
Organization Name:DANIEL WEISBECKER DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISBECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-671-7887
Mailing Address - Street 1:94-1030 WAIPIO UKA ST STE 104
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4084
Mailing Address - Country:US
Mailing Address - Phone:808-671-7887
Mailing Address - Fax:808-671-7887
Practice Address - Street 1:94-1030 WAIPIO UKA ST STE 104
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4084
Practice Address - Country:US
Practice Address - Phone:808-671-7887
Practice Address - Fax:808-671-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty