Individual
ETHEN AXEL WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
162 HUAALANI DR, HILO, HI 96720
(808) 936-7598
Mailing address
162 HUAALANI DR, HILO, HI 96720
(808) 936-7598
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17049
HI
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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