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General NPI Number Information
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NPI Number | 1407115991
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Entity Type | Organization
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Legal Business Name | SQUARE ROOT COMPUTERS INC
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 1279 S KING ST # 1
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City | HONOLULU
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State | HI
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Zip | 96814-2270
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Country | US
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Telephone | 512-369-2242
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Fax | 888-731-7575
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Provider Business Mailing Address
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Address Line | 1279 S KING ST # 1
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City | HONOLULU
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State | HI
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Zip | 96814-2270
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Country | US
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Telephone | 512-369-2242
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Fax | 888-731-7575
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUSTIN HAYS
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Credential | LAC, MAOM
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Telephone | 512-369-2242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1026
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License Number State | HI
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