Individual
MR. JEREMIAH JAKE JUSTESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
59-524 AUKAUKA PL, HALEIWA, HI 96712-9519
(808) 392-6046
Mailing address
59-524 AUKAUKA PL, HALEIWA, HI 96712-9519
(808) 392-6046
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9741
HI
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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