Individual
COLLIN PATRICK GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2940 AUKOI ST, LIHUE, HI 96766-1607
(808) 647-4696
Mailing address
2940 AUKOI ST, LIHUE, HI 96766-1607
(808) 647-4696
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12954
HI
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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