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Individual

MARTINA VESELA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
28 E KUU AKU LN UNIT 512, LAHAINA, HI 96761-2758
(808) 866-6776
Mailing address
28 E KUU AKU LN UNIT 512, LAHAINA, HI 96761-2758
(808) 866-6776

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT12900
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H01092619
DRIVERS LICENSE
HI
01
NONE
NONE
Enumeration date
11/20/2019
Last updated
11/20/2019
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