Individual
FREDERICK JOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
94-398 KAHUANANI ST, WAIPAHU, HI 96797-3510
(808) 678-2034
(808) 678-2034
Mailing address
94-398 KAHUANANI ST, WAIPAHU, HI 96797-3510
(808) 678-2034
(808) 678-2034
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
05/01/2020
Last updated
05/01/2020
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