Individual
MR. RICKY DESI BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
45-270 WILLIAM HENRY RD, STE 205, KANEOHE, HI 96744-5808
(808) 235-6677
(808) 236-0844
Mailing address
45-270 WILLIAM HENRY RD, STE 205, KANEOHE, HI 96744-5808
(808) 235-6677
(808) 236-0844
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC420
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0098993
HMSA
HI
Enumeration date
09/05/2007
Last updated
02/21/2017
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