Individual
JACY C CABAEL-TELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 CAMPUS RD, HONOLULU, HI 96822-2217
(808) 956-8111
Mailing address
2069 CALIFORNIA AVE APT 14H, WAHIAWA, HI 96786-2779
(808) 386-4056
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/17/2021
Last updated
04/17/2021
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