Healthcare Provider Details

I. General information

NPI: 1790875151
Provider Name (Legal Business Name): JANICE DAUW L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15-2045 KAHILI AVE
KEA'AU HI
96749-2323
US

IV. Provider business mailing address

PO BOX 492323
KEAAU HI
96749-2323
US

V. Phone/Fax

Practice location:
  • Phone: 541-929-7462
  • Fax:
Mailing address:
  • Phone: 808-982-4309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU840
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: