Individual
MS. VICKI LYNN HUTCHISON NIEDERKORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
75-184 HUALALAI RD, KAILUA KONA, HI 96740-1719
(808) 334-4400
Mailing address
75-184 HUALALAI RD, KAILUA KONA, HI 96740-1719
(808) 334-4400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1268
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C0252431
HMSA BILLING NUMBER
HI
05
—
171017886801
—
HI
Enumeration date
08/05/2007
Last updated
06/10/2008
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