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Organization

PACIFIC SPINE & REHAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC WRUCK DC (OWNER)
(808) 250-1166
Entity
Organization

Contact information

Practice address
95 LONO AVE, SUITE 105, KAHULUI, HI 96732-1610
(808) 250-1166
Mailing address
PO BOX 1140, MAKAWAO, HI 96768-1140
(808) 250-1166

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
DC726
HI
225100000X
Physical Therapist
Primary
PTA-241
HI

Other

Enumeration date
02/18/2016
Last updated
02/18/2016
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