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Individual

MS. LEENA M GRAVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4590 HANA HIGHWAY, HANA, HI 96713
(808) 248-7515
(808) 248-7223
Mailing address
PO BOX 807, HANA, HI 96713-0807
(808) 248-7515
(808) 248-7223

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MAT-5368
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MAT-5368
HAWAII LICENSE
HI
Enumeration date
09/25/2008
Last updated
09/25/2008
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