Organization
JASMINE RIVERA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE RIVERA (OWNER)
(808) 277-6303
Entity
Organization
Contact information
Practice address
489 KOPAA PL, WAILUKU, HI 96793
(808) 277-6303
Mailing address
489 KOPAA PL, WAILUKU, HI 96793
(808) 277-6303
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
W02219304-01
HI
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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