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Individual

ALICIA VAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
380 HUKU LII PL, SUITE #107, KIHEI, HI 96753-7043
(808) 875-4466
(808) 874-3899
Mailing address
380 HUKU LII PL, SUITE #107, KIHEI, HI 96753-7043
(808) 875-4466
(808) 874-3899

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
6767 TG
TX
152W00000X
Optometrist
Primary
OD 644
HI

Other

Enumeration date
12/15/2006
Last updated
10/19/2009
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