Individual
JENNIFER FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
75-5995 KUAKINI HWY STE 603, KAILUA KONA, HI 96740-2124
(808) 333-6404
Mailing address
81-902 NAPE ST, KEALAKEKUA, HI 96750-8110
(808) 333-6404
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12913
HI
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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