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General NPI Number Information
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NPI Number | 1861795908
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Entity Type | Organization
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Legal Business Name | OAHU CHIROPRACTIC - WINDWARD LLC.
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 46-001 KAMEHAMEHA HIGHWAY SUITE 420
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City | KANEOHE
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State | HI
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Zip | 96744-3711
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Country | US
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Telephone | 808-247-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 1270 AKELE ST
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City | KAILUA
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State | HI
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Zip | 96734-4221
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Country | US
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Telephone | 808-927-7951
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. RICHARD L RODGERS II
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Credential | D.C.
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Telephone | 808-927-7951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1181
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License Number State | HI
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