Provider Demographics
NPI:1871775411
Name:LUI, GREG LANCE (DC)
Entity type:Individual
Prefix:DR
First Name:GREG
Middle Name:LANCE
Last Name:LUI
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:1126 12TH AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3715
Mailing Address - Country:US
Mailing Address - Phone:808-739-0704
Mailing Address - Fax:808-739-0704
Practice Address - Street 1:1126 12TH AVE
Practice Address - Street 2:STE 102
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3715
Practice Address - Country:US
Practice Address - Phone:808-739-0704
Practice Address - Fax:808-739-0704
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52792Medicare PIN