Provider Demographics
NPI:1760620652
Name:ODA, AARIES T (DC)
Entity Type:Individual
Prefix:DR
First Name:AARIES
Middle Name:T
Last Name:ODA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4156 PUAOLE ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1410
Mailing Address - Country:US
Mailing Address - Phone:808-647-4500
Mailing Address - Fax:
Practice Address - Street 1:3125 AKAHI ST
Practice Address - Street 2:SUITE 22
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1106
Practice Address - Country:US
Practice Address - Phone:808-245-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC1135111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor