Individual
SANDRA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
73-4863 ANINI ST, KAILUA KONA, HI 96740-9233
(808) 325-6795
Mailing address
73-4863 ANINI ST, KAILUA KONA, HI 96740-9233
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MAT 4538
HI
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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