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Individual

JACO J VAN DELDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
932 WARD AVE, 7TH FLOOR, HONOLULU, HI 96814-2131
(808) 381-8947
Mailing address
1944A 10TH AVE, HONOLULU, HI 96816-2910
(808) 381-8947

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1582
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A20852-8
HMSA
HI
Enumeration date
02/03/2007
Last updated
09/16/2009
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