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Individual

MR. JOHN T MIZOGUCHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
111 HANA HWY STE 107, KAHULUI, HI 96732-2300
(808) 877-8717
(808) 877-8718
Mailing address
111 HANA HWY STE 107, KAHULUI, HI 96732-2300
(808) 877-8717
(808) 877-8718

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT151
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
52704601
HI
Enumeration date
08/31/2006
Last updated
07/08/2007
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