Individual
DR. JESSE BRODERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
74-5620 PALANI RD STE A, SUITE 102, KAILUA KONA, HI 96740-3640
(808) 329-7797
(808) 329-2748
Mailing address
74-5620A PALANI RD, SUITE 102, KAILUA KONA, HI 96740-3100
(808) 329-7797
(808) 329-2748
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
978
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
244335
HMSA PIN NUMBER
HI
Enumeration date
10/24/2006
Last updated
01/08/2011
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