Organization
NONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIANA ROSE L AHUE (STUDENT)
(808) 223-0936
Entity
Organization
Contact information
Practice address
58-290 KAMEHAMEHA HWY, HALEIWA, HI 96712-9716
(808) 223-0936
Mailing address
58-290 KAMEHAMEHA HWY, HALEIWA, HI 96712-9716
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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