Provider Demographics
NPI:1073654109
Name:MORRIS, BOBBIE (LICAC)
Entity type:Individual
Prefix:MS
First Name:BOBBIE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 AINALAKO RD
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3713
Mailing Address - Country:US
Mailing Address - Phone:808-933-1200
Mailing Address - Fax:808-959-2227
Practice Address - Street 1:620 AINALAKO RD
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3713
Practice Address - Country:US
Practice Address - Phone:808-933-1200
Practice Address - Fax:808-959-2227
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI535171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist