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Individual

JACOB D RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
91-1001 KAIMALIE ST # 106, EWA BEACH, HI 96706-6247
(808) 774-7817
Mailing address
91-1001 KAIMALIE ST # 106, EWA BEACH, HI 96706-6247
(808) 774-7817
(808) 774-7817

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1658
HI
111N00000X
Chiropractor
Primary
5555
NC

Other

Enumeration date
10/10/2022
Last updated
04/28/2026
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