Provider Demographics
NPI:1881647154
Name:POPPAS HEATHERS, CARASTONA K (DC)
Entity type:Individual
Prefix:DR
First Name:CARASTONA
Middle Name:K
Last Name:POPPAS HEATHERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 ULUNIU ST STE 404
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2534
Mailing Address - Country:US
Mailing Address - Phone:808-260-7909
Mailing Address - Fax:808-312-3383
Practice Address - Street 1:354 ULUNIU ST STE 404
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2534
Practice Address - Country:US
Practice Address - Phone:808-262-2226
Practice Address - Fax:808-312-3383
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC-1353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME098017OtherANTHEM BLUE CROSS BLUE SH