Individual
NICOLE P BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 S BERETANIA ST STE 550, HONOLULU, HI 96814-1880
(808) 381-3947
Mailing address
1401 S BERETANIA ST STE 550, HONOLULU, HI 96814-1880
(808) 381-3947
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-5778
HI
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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