Provider Demographics
NPI:1396960258
Name:HENDLIN, TIMOTHY HALE (DC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:HALE
Last Name:HENDLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75166 KALANI STREET
Mailing Address - Street 2:SUITE 203 HENDLIN CHIROPRACTIC HEALTH CENTER
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740
Mailing Address - Country:US
Mailing Address - Phone:808-329-5155
Mailing Address - Fax:808-329-2726
Practice Address - Street 1:75166 KALANI STREET
Practice Address - Street 2:SUITE 203 HENDLIN CHIROPRACTIC HEALTH CENTER
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:808-329-5155
Practice Address - Fax:808-329-2726
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI271111N00000X
CA14391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI98889OtherHMSA
0000QCCF6Medicare ID - Type Unspecified