Debra Kettleson INC

NPI #1134525546 in Hilo, Hawaii

Provider Information

NPI Number: 1134525546
Entity Type: Organization
Organization Name: Debra Kettleson INC
Primary Specialty: Family Medicine
Enumeration Date: Nov 12, 2014
Last Updated: Jan 5, 2015

Practice Location

Address: 670 PONAHAWAI ST STE 221
City: Hilo
State: Hawaii
ZIP Code: 96720-7829
Phone: (808) 365-5988

Authorized Official

Name: DEBRA LYNN KETTLESON
Title: OWNER/PROVIDER
Phone: (808) 365-5988

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Geriatric Medicine — Geriatric Medicine	207QG0300X
Family Medicine	207Q00000X	Primary

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