Individual
MR. HARRISON VIDINHA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 1107 UAU RD, KURTISTOWN, HI 96760
(808) 315-4367
Mailing address
PO BOX 1506, KURTISTOWN, HI 96760
(808) 315-4367
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
H00339928
HI
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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