Individual
BEVERLY GRANDE KOKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
2-2527 KAUMUALII HWY, KALAHEO, HI 96741-8309
(808) 332-5580
Mailing address
PO BOX 150, ELEELE, HI 96705-0150
(808) 346-8070
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14850
HI
Other
Enumeration date
01/28/2017
Last updated
01/28/2017
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