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General NPI Number Information
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NPI Number | 1972043388
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Entity Type | Organization
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Legal Business Name | LICE CLINICS OF HAWAII
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Dates
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Enumeration Date | 03/03/2017
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Last Update Date | 03/03/2017
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Provider Practice Location Address
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Address Line | 300 OHUKAI RD B-319
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City | KIHEI
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State | HI
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Zip | 96753-7040
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Country | US
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Telephone | 808-866-9060
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Fax |
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Provider Business Mailing Address
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Address Line | 300 OHUKAI RD B-319
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City | KIHEI
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State | HI
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Zip | 96753-7040
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Country | US
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Telephone | 808-866-9060
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. SUSAN BARRIE DESMOND
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Credential |
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Telephone | 808-283-4247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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