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Individual

LYNDA L LA FORM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MAT

Contact information

Practice address
615 PIIKOI ST, SUITE 1210, HONOLULU, HI 96814-3116
(808) 596-7300
(808) 596-7305
Mailing address
1475 LINAPUNI ST, #1114, HONOLULU, HI 96819-3569
(808) 457-2976

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-4029
HI

Other

Enumeration date
03/14/2007
Last updated
07/08/2007
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