Individual
MR. TINA WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75-6082 ALII DR, STE 10A, KAILUA KONA, HI 96740-4303
(808) 990-3274
Mailing address
PO BOX 4084, KAILUA KONA, HI 96745-4084
(808) 990-3274
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
MAT 11747
HI
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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