Provider Demographics
NPI:1265586747
Name:NOWICKI, CHRISTOPHER MITCHELL (DC, DABCO)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MITCHELL
Last Name:NOWICKI
Suffix:
Gender:M
Credentials:DC, DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 KAMEHAMEHA HWY STE 309
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2638
Mailing Address - Country:US
Mailing Address - Phone:808-456-5553
Mailing Address - Fax:808-455-6520
Practice Address - Street 1:803 KAMEHAMEHA HWY STE 309
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2638
Practice Address - Country:US
Practice Address - Phone:808-456-5553
Practice Address - Fax:808-455-6520
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC #304111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIT83235Medicare UPIN