Individual
MRS. KRYSIA MAY KU'UIPOLANI AGOSTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.C.T,
Contact information
Practice address
87-128 LILIANA ST, WAIANAE, HI 96792-3142
(808) 953-9532
Mailing address
4107 EILEEN ST, LAS VEGAS, NV 89115-0146
(702) 772-0192
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/02/2012
Last updated
01/23/2014
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