NPI 1437313046

Jennifer Diane Broderson, LMT

Practitioner Specialist Kailua Kona, HI

Practice location

Address: 74-5620 Palani Rd Suite 102, Kailua Kona, HI 96740-3640
Phone: (808) 329-7797
Fax: (808) 329-2748

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence MAT10080 (HI)

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Registry record

NPI: 1437313046
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Jul 2008
Record last updated: 12 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.