Organization
KAUAI OPTOMETRIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN BELISLE O.D. (OWNER)
(808) 822-3733
Entity
Organization
Contact information
Practice address
4-901 KUHIO HWY, STE B, KAPAA, HI 96746-1576
(808) 822-3733
(808) 822-7355
Mailing address
4-901 KUHIO HWY, STE B, KAPAA, HI 96746-1576
(808) 822-3733
(808) 822-7355
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD181
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01770901
—
HI
Enumeration date
07/13/2007
Last updated
04/01/2011
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