Individual
MS. AGNES R VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
73-1105 ALIHILANI DR, KAILUA KONA, HI 96740-9405
(808) 333-5840
Mailing address
PO BOX 704, KAILUA KONA, HI 96745-0704
(808) 333-5840
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT 1596
HI
Other
Enumeration date
09/01/2009
Last updated
09/01/2009
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