Individual
MS. LISA DIANE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
77-6425 KUAKINI HWY, SUITE D103, KAILUA KONA, HI 96740-3213
(808) 937-7611
Mailing address
73-4536 OLD MAMALAHOA HWY, UNIT A, KAILUA KONA, HI 96740-8632
(808) 089-5136
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT - 4487
HI
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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