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General NPI Number Information
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NPI Number | 1609376284
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Entity Type | Organization
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Legal Business Name | KIMPACT WELLNESS LIMITED
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 7192 KALANIANAOLE HWY
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City | HONOLULU
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State | HI
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Zip | 96825-1800
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Country | US
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Telephone | 760-583-1997
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Fax |
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Provider Business Mailing Address
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Address Line | 1246 AKELE ST
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City | KAILUA
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State | HI
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Zip | 96734-4221
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HYELEE KIM
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Credential | NP
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Telephone | 760-583-1997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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