Provider Demographics
NPI:1356425532
Name:RAQUEL, GEORGE ERMANO (D C)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ERMANO
Last Name:RAQUEL
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-216 FARRINGTON HWY STE B1-3
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1900
Mailing Address - Country:US
Mailing Address - Phone:808-676-1717
Mailing Address - Fax:808-678-1122
Practice Address - Street 1:94-216 FARRINGTON HWY STE B1-3
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1900
Practice Address - Country:US
Practice Address - Phone:808-676-1717
Practice Address - Fax:808-678-1122
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI815111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation