Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 868 | HI |
NPI | 1184995714 |
---|---|
Provider Name | Richard Paul Sargent |
First Address | Lahaina, HI 96761-8404 |
Second Address | Lahaina, HI 96761-8404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2012 |
Last Update Date | 12/01/2012 |