Individual
JACKSON KONANE BRUMBLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LMT,
Contact information
Practice address
105 NAKEKE PL, WAHIAWA, HI 96786-2749
(808) 286-3891
Mailing address
105 NAKEKE PL, WAHIAWA, HI 96786-2749
(808) 286-3891
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-16900
HI
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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