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Individual

JESSICA A MONTANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.A.C

Contact information

Practice address
1170 MAKAWAO AVE STE 103, MAKAWAO, HI 96768-9448
(808) 633-6123
Mailing address
30 OLINDA RD, MAKAWAO, HI 96768-7360
(808) 633-6123

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
981
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ACU-981
HAWAII STATE LICENSE
HI
Enumeration date
06/29/2012
Last updated
02/12/2020
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