Provider Demographics
NPI:1861795908
Name:OAHU CHIROPRACTIC - WINDWARD LLC.
Entity type:Organization
Organization Name:OAHU CHIROPRACTIC - WINDWARD LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:808-927-7951
Mailing Address - Street 1:1270 AKELE ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4221
Mailing Address - Country:US
Mailing Address - Phone:808-927-7951
Mailing Address - Fax:
Practice Address - Street 1:46-001 KAMEHAMEHA HIGHWAY
Practice Address - Street 2:SUITE 420
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3711
Practice Address - Country:US
Practice Address - Phone:808-247-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty