Provider Demographics
NPI:1700436805
Name:HONOLULU ELITE CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HONOLULU ELITE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARIES
Authorized Official - Middle Name:T
Authorized Official - Last Name:ODA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-647-4500
Mailing Address - Street 1:725A 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-7102
Mailing Address - Country:US
Mailing Address - Phone:808-647-4500
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 808
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4404
Practice Address - Country:US
Practice Address - Phone:808-647-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty