Individual
CARA LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
68-1845 WAIKOLOA RD, WAIKOLOA, HI 96738-5584
(808) 557-8110
Mailing address
PO BOX 1778, KAMUELA, HI 96743-1778
(807) 960-7108
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LMT #4621
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225700000X
TAXONOMY
HI
Enumeration date
10/01/2015
Last updated
10/01/2015
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