Provider Demographics
NPI:1124696430
Name:BARBOUR, ANTOINETTE PUALANI (CHIROPRACTOR)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:PUALANI
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-530 MAKALEA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5941
Mailing Address - Country:US
Mailing Address - Phone:720-217-7591
Mailing Address - Fax:
Practice Address - Street 1:95-390 KUAHELANI AVE STE 3E
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1190
Practice Address - Country:US
Practice Address - Phone:808-376-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty