Organization
DR LISA TAKETA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA TAKETA (OWNER)
(808) 868-8068
Entity
Organization
Contact information
Practice address
7 AEWA PL, MAKAWAO, HI 96768-8882
(808) 868-8063
Mailing address
4450 KULA HWY UNIT 264, KULA, HI 96790-3018
(808) 868-8063
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
ACU-338
HI
Other
Enumeration date
07/25/2015
Last updated
07/25/2015
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