Organization
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Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIRDRE IMAGIRE (OWNER/MANAGER)
(408) 809-1844
Entity
Organization
Contact information
Practice address
16-590 OLD VOLCANO RD, KEAAU, HI 96749
(408) 809-1844
Mailing address
16-590 OLD VOLCANO RD, KEAAU, HI 96749-8158
(408) 809-1844
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-1332
HI
Other
Enumeration date
06/22/2018
Last updated
07/23/2018
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