Individual
JOHN F BETLACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.T.
Contact information
Practice address
77-6425 KUAKINI HWY, KAILUA KONA, HI 96740-3213
(808) 557-1420
Mailing address
PO BOX 390562, KEAUHOU, HI 96739-0562
(808) 557-1420
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MASSAGE THER. #7144
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JB1064276
ASH NETWORK
HI
Enumeration date
08/26/2009
Last updated
08/26/2009
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