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Individual
MRS. CAROL ANN IADELUCA-MYRIANTHIS
Active
Individual
MRS. CAROL ANN IADELUCA-MYRIANTHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, PSYD
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
474
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01853401
—
HI
05
—
01853402
—
HI
01
—
A19867
HMSA KA'U
HI
01
—
D19861
HMSA PAHOA
HI
Enumeration date
08/13/2006
Last updated
05/23/2008
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