Individual
DAVID CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, LMT
Contact information
Practice address
78 HAELE PL, MAKAWAO, HI 96768-8054
(808) 298-6417
Mailing address
78 HAELE PL, MAKAWAO, HI 96768-8054
(808) 298-6417
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1057
HI
225700000X
Massage Therapist
8484
HI
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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