Individual
MR. KENNETH RAYMOND BELLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
755 SCOTT CIR, 15TH MEDICAL GROUP, HICKAM AFB, HI 96853-5399
(808) 448-6261
(808) 448-6740
Mailing address
755 SCOTT CIR, 15TH MEDICAL GROUP, HICKAM AFB, HI 96853-5399
(808) 448-6261
(808) 448-6740
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH-1332
HI
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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