Individual
MRS. MICHELE ANN EVANGELISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
1270 OLAPA STREET, LANAI CITY, HI 96763
(808) 565-8009
Mailing address
PO BOX 631552, LANAI CITY, HI 96763-1552
(808) 565-8009
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-14505
HI
Other
Enumeration date
07/14/2017
Last updated
07/14/2017
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