Individual
CAMERON MODISETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
755 SCOTT CIR, HICKAM AFB, HI 96853-5399
(808) 448-6203
(808) 448-6226
Mailing address
755 SCOTT CIR, HICKAM AFB, HI 96853-5399
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/29/2009
Last updated
07/29/2009
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