Provider Demographics
NPI:1881051795
Name:HEALY, BRYCE (ND)
Entity type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:
Last Name:HEALY
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 AUPUNI ST STE 115
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4260
Mailing Address - Country:US
Mailing Address - Phone:949-292-8467
Mailing Address - Fax:
Practice Address - Street 1:101 AUPUNI ST STE 115
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4260
Practice Address - Country:US
Practice Address - Phone:808-638-4770
Practice Address - Fax:808-999-0660
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI277175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ175F00000XOtherNATUROPATH
HI175F00000XOtherNATUROPATH