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General NPI Number Information
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NPI Number | 1679644777
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Entity Type | Individual
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Provider Name | LORI A CAMPBELL LAC
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Gender | Female
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Dates
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Enumeration Date | 11/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | HC 1 BOX 5655 16-1874 36TH AVE
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City | KEAAU
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State | HI
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Zip | 96749-9404
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Country | US
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Telephone | 808-982-5846
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 5655 16-1874 36TH AVE.
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City | KEAAU
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State | HI
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Zip | 96749-9404
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Country | US
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Telephone | 808-982-5846
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Fax | 808-982-9601
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 484
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License Number State | HI
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