Provider Demographics
NPI:1659913937
Name:FLEWELLING, BRANDON (L AC)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:
Last Name:FLEWELLING
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 KILAUEA AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5308
Mailing Address - Country:US
Mailing Address - Phone:808-255-7815
Mailing Address - Fax:808-748-0326
Practice Address - Street 1:4747 KILAUEA AVE STE 115
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5308
Practice Address - Country:US
Practice Address - Phone:808-255-7815
Practice Address - Fax:808-748-0326
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1051171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist