Individual
SUE BOURGEOISHUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
35 LUNALILO STREET, UNIT 102, WAILUKU, HI 96793
(808) 244-6363
(808) 249-2151
Mailing address
35 LUNALILO ST, UNIT 102, WAILUKU, HI 96793
(808) 244-6363
(808) 249-2151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LMT4374
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMT4374
LICENSE
HI
Enumeration date
05/17/2007
Last updated
07/08/2007
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