Provider Demographics
NPI:1578770137
Name:SPEEDY ALTERGOTT, KAREN (LAC, MS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SPEEDY ALTERGOTT
Suffix:
Gender:F
Credentials:LAC, MS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:SPEEDY
Other - Last Name:ALTERGOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, MS
Mailing Address - Street 1:68-3759 PIKI PL
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-5223
Mailing Address - Country:US
Mailing Address - Phone:808-990-6996
Mailing Address - Fax:
Practice Address - Street 1:68-3759 PIKI PL
Practice Address - Street 2:
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738-5223
Practice Address - Country:US
Practice Address - Phone:808-990-6996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU 682171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist