Individual
MR. JEREMY HANNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
135 S WAKEA AVE STE 112, KAHULUI, HI 96732-1385
(808) 385-4048
(808) 492-0778
Mailing address
135 S WAKEA AVE STE 112, KAHULUI, HI 96732-1385
(808) 385-4048
(808) 492-0778
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3473
HI
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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