Individual
BETSY JO KALLENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 N MARKET ST, WAILUKU, HI 96793-1718
(808) 242-8788
Mailing address
22A AUOLI DR, MAKAWAO, HI 96768-9312
(360) 770-4026
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12592
HI
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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