Provider Demographics
NPI:1720233497
Name:DUNLAP, KRISTYN (LAC)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:DUNLAP
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 1:233 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2218
Mailing Address - Country:US
Mailing Address - Phone:808-281-1319
Mailing Address - Fax:
Practice Address - Street 1:233 S MARKET ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2218
Practice Address - Country:US
Practice Address - Phone:808-281-1319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-22
Last Update Date:2008-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI719171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist