Individual
ESYL MAE ORTAL MACOCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
4347 RICE ST STE 207, LIHUE, HI 96766-1335
(808) 482-7841
Mailing address
4121 RICE ST APT 308, LIHUE, HI 96766-1475
(808) 482-7841
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-17660
HI
Other
Enumeration date
12/06/2023
Last updated
03/31/2026
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