Organization
BOTOX KAILUA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIANNA SORTLAND (OWNER)
(808) 272-0444
Entity
Organization
Contact information
Practice address
1005 KEOLU DR, KAILUA, HI 96734-3873
(808) 272-0444
Mailing address
1005 KEOLU DR, KAILUA, HI 96734-3873
(808) 272-0444
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/05/2025
Last updated
09/05/2025
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