Organization
THE UPCOUNTRY MASSAGE CO,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHELLE 'NIKKI' JANSSEN LMT (OWNER/PRINCIPAL THERAPIST)
(808) 572-5959
Entity
Organization
Contact information
Practice address
7 AEWA PL STE 12, MAKAWAO, HI 96768-8882
(808) 572-5959
(808) 572-0394
Mailing address
PO BOX 692, KULA, HI 96790-0692
(808) 572-5959
(808) 572-0394
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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