Provider Demographics
NPI:1043704935
Name:GUZMAN, AMADA LUZ (DC)
Entity type:Individual
Prefix:DR
First Name:AMADA
Middle Name:LUZ
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223489
Mailing Address - Street 2:
Mailing Address - City:PRINCEVILLE
Mailing Address - State:HI
Mailing Address - Zip Code:96722-3489
Mailing Address - Country:US
Mailing Address - Phone:916-969-0754
Mailing Address - Fax:808-826-7600
Practice Address - Street 1:5-4280 KUHIO HWY STE B206
Practice Address - Street 2:
Practice Address - City:PRINCEVILLE
Practice Address - State:HI
Practice Address - Zip Code:96722-5451
Practice Address - Country:US
Practice Address - Phone:808-826-7000
Practice Address - Fax:808-826-7600
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC-1398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor