Provider Demographics
NPI:1669745816
Name:KEY TO LIFE CHIROPRACTIC INC
Entity type:Organization
Organization Name:KEY TO LIFE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-669-4035
Mailing Address - Street 1:5095 NAPILIHAU ST
Mailing Address - Street 2:STE 205
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-8800
Mailing Address - Country:US
Mailing Address - Phone:808-669-4035
Mailing Address - Fax:808-669-0740
Practice Address - Street 1:5095 NAPILIHAU ST
Practice Address - Street 2:STE 205
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-8800
Practice Address - Country:US
Practice Address - Phone:808-669-4035
Practice Address - Fax:808-669-0740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty