Provider Demographics
NPI:1124877253
Name:LOBENBERG, KATHLEEN DENISE (DC)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:DENISE
Last Name:LOBENBERG
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 1:401 SIGNER BLVD APT D
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-7977
Mailing Address - Country:US
Mailing Address - Phone:815-715-6803
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 1002
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4405
Practice Address - Country:US
Practice Address - Phone:808-465-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC-1598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor