Individual
STACEY ALLAN PERBERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
54-224B HAUULA HOMESTEAD RD, HAUULA, HI 96717-9638
(808) 382-3875
Mailing address
PO BOX 959, HAUULA, HI 96717-0959
(808) 382-3875
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-12848
HI
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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