Most Relevant Information
Provider Data
| NPI Number: | 1003485764 |
| Provider Name: | LARISSA GEMER ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/17/2021 |
| Last Updated: | 06/17/2021 |
Provider Practice Location
73-1507 HAO ST
KAILUA KONA
HI
967409133
Practice Location Phone/Fax
| Phone: | 9202655584 |
| Fax: |
Provider Mailing Location
73-1507 HAO ST
KAILUA KONA
HI
967409133
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |