Individual
JESSICA LEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
180 DICKENSON ST, SUITE 205, LAHAINA, HI 96761-1215
(808) 250-1124
Mailing address
17A MAKAI PL, KULA, HI 96790-8518
(808) 250-1124
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6639
HI
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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