Individual
MS. MIRIAM KU'ULEI MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
98-020 KAMEHAMEHA HWY, SUITE 203, AIEA, HI 96701-5159
(808) 488-2221
(808) 488-2221
Mailing address
2370 HOOHOIHOI ST, PEARL CITY, HI 96782-1647
(808) 456-3740
(808) 456-3740
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MAT-2882
HI
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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