Individual
MRS. JENNIFER DIANE BRODERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
74-5620 PALANI RD, SUITE 102, KAILUA KONA, HI 96740-3640
(808) 329-7797
(808) 329-2748
Mailing address
74-5620 PALANI RD, SUITE 102, KAILUA KONA, HI 96740-3640
(808) 329-7797
(808) 329-2748
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MAT10080
HI
Other
Enumeration date
07/12/2008
Last updated
07/12/2008
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