Individual
JACK FONDERWHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1010 S KING ST STE 217, HONOLULU, HI 96814-1703
(808) 593-7717
Mailing address
260 ELELUPE RD, HONOLULU, HI 96821-2209
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1259
HI
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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