Healthcare Provider Details

I. General information

NPI: 1972762359
Provider Name (Legal Business Name): HOWARD RODGERS DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65-1298B KAWAIHAE ROAD
KAMUELA HI
96743-0729
US

IV. Provider business mailing address

PO BOX 729
KAMUELA HI
96743-0729
US

V. Phone/Fax

Practice location:
  • Phone: 808-885-7719
  • Fax: 808-885-4450
Mailing address:
  • Phone: 808-885-7719
  • Fax: 808-885-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC77
License Number StateHI

VIII. Authorized Official

Name: DR. HOWARD RODGERS
Title or Position: OWNER PRESIDENT
Credential: DC
Phone: 808-885-7719