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Individual

IMMANUEL KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
5113 MAUNALANI CIR, HONOLULU, HI 96816-4019
(808) 695-2860
Mailing address
1806 PALOLO AVE APT D, HONOLULU, HI 96816-2945
(808) 936-4851

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-314-0
HI

Other

Enumeration date
05/20/2024
Last updated
05/20/2024
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