MR. Jeremiah Jake Justesen, L.M.T.

NPI #1245448570 in Haleiwa, Hawaii

Provider Information

NPI Number: 1245448570
Entity Type: Individual
Name: MR. Jeremiah Jake Justesen, L.M.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: L.M.T.
Enumeration Date: May 18, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 59-524 AUKAUKA PL
City: Haleiwa
State: Hawaii
ZIP Code: 96712-9519
Phone: (808) 392-6046

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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