Individual
HARLEY KAUAI MAKANI NESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
4325 IOELA PL, KILAUEA, HI 96754
(808) 635-3973
Mailing address
4325 IOELA PL, P.O. BOX 638, KILAUEA, HI 96754
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MAT-14381
HI
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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