Individual
AVERY MADISON CHESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1814 LILIHA ST, HONOLULU, HI 96817-2324
(281) 881-7224
Mailing address
95-1053 KOOLANI DR APT 24, MILILANI, HI 96789-4992
(281) 881-7224
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
617
HI
Other
Enumeration date
12/16/2021
Last updated
12/16/2021
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