Individual
RYAN ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2404 BURBANK ST, HONOLULU, HI 96817-1431
(808) 224-3107
Mailing address
2404 BURBANK ST, HONOLULU, HI 96817-1431
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10942
HI
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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