Kyle Hiromi Hatanaka, LAC

NPI #1053960286 in Boise, Idaho

Provider Information

NPI Number: 1053960286
Entity Type: Individual
Name: Kyle Hiromi Hatanaka, LAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Acupuncturist
Credential: LAC
Enumeration Date: Sep 10, 2019
Last Updated: Sep 10, 2019

Practice Location

Address: 9450 #120 FAIRVIEW AVENUE
City: Boise
State: Idaho
ZIP Code: 83704
Phone: (530) 515-1064

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X	Primary

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