Individual
KAANOHIOKALA PEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
17-4221 HUINA RD., KURTISTOWN, HI 96760-8213
(808) 333-7890
(808) 443-0799
Mailing address
16-566 KEAAU PAHOA RD STE 188-201, KEAAU, HI 96749-8137
(808) 333-7890
(808) 443-0799
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MAT-9551
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689085151
MASSAGE THERAPY
HI
Enumeration date
05/18/2014
Last updated
12/15/2017
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