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General NPI Number Information
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NPI Number | 1053081273
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Entity Type | Organization
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Legal Business Name | KAILUA ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 09/18/2021
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Last Update Date | 09/18/2021
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Provider Practice Location Address
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Address Line | 320 ULUNIU ST STE 2
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City | KAILUA
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State | HI
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Zip | 96734-2529
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Country | US
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Telephone | 808-262-4550
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Fax | 855-594-5059
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Provider Business Mailing Address
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Address Line | 320 ULUNIU ST STE 2
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City | KAILUA
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State | HI
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Zip | 96734-2529
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Country | US
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Telephone | 808-262-4550
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Fax | 855-594-5059
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JENNIFER SLOCUM
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Credential |
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Telephone | 808-262-4550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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