Provider Demographics
NPI:1699952291
Name:WONG FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:WONG FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-943-2872
Mailing Address - Street 1:1347 KAPIOLANI BLVD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4512
Mailing Address - Country:US
Mailing Address - Phone:808-943-2872
Mailing Address - Fax:808-947-6570
Practice Address - Street 1:1347 KAPIOLANI BLVD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4512
Practice Address - Country:US
Practice Address - Phone:808-943-2872
Practice Address - Fax:808-947-6570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center