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General NPI Number Information
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NPI Number | 1235667221
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Entity Type | Organization
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Legal Business Name | HEALING SEAS ACUPUNCTURE KAUAI LLC
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 06/02/2017
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Provider Practice Location Address
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Address Line | 5116 KAHANA ST
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City | KAPAA
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State | HI
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Zip | 96746-2152
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Country | US
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Telephone | 808-278-3785
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Fax |
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Provider Business Mailing Address
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Address Line | 5116 KAHANA ST
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City | KAPAA
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State | HI
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Zip | 96746-2152
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Country | US
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Telephone | 808-278-3785
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. JAN P DUNN
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Credential | L.AC., DIPL.AC.
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Telephone | 808-278-3785
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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 | 1179
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License Number State | HI
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