Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 293 | HI |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 293 | HI |
NPI | 1366749061 |
---|---|
Provider Name | Dr. Kurt Halverson |
First Address | Hilo, HI 96720-4378 |
Second Address | Hilo, HI 96720-4378 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2011 |
Last Update Date | 16/02/2011 |