Provider Demographics
NPI:1497089817
Name:LIU, OLIVIA (LAC)
Entity Type:Individual
Prefix:MISS
First Name:OLIVIA
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1065
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-1065
Mailing Address - Country:US
Mailing Address - Phone:708-860-0179
Mailing Address - Fax:
Practice Address - Street 1:3636 LOWER HONOAPIILANI RD
Practice Address - Street 2:SUITE 3
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-5916
Practice Address - Country:US
Practice Address - Phone:808-669-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI846171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist