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Individual

JESSICA STARE VALANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
602 KAILUA RD, #202, KAILUA, HI 96734-2841
(808) 277-7641
Mailing address
602 KAILUA RD, #202, KAILUA, HI 96734-2841
(808) 277-7641

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2677
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000267864
HMSA
HI
05
59164501
HI
Enumeration date
02/23/2007
Last updated
02/22/2012
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