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General NPI Number Information
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NPI Number | 1508300351
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Entity Type | Individual
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Provider Name | BRAD MCLAUGHLIN
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Gender | Male
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 95 LONO AVE SUITE #105
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City | KAHULUI
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State | HI
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Zip | 96732-1610
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Country | US
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Telephone | 808-873-0733
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Fax |
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Provider Business Mailing Address
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Address Line | 2136 KONOU PL APT. #101
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City | KIHEI
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State | HI
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Zip | 96753-8775
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Country | US
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Telephone | 949-547-8597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | PTA 326
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License Number State | HI
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