Individual
ODYSSEY GADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
351 EHILANI ST, MAKAWAO, HI 96768-8319
(808) 757-8268
Mailing address
351 EHILANI ST, MAKAWAO, HI 96768-8319
(808) 757-8268
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-17688-0
HI
225700000X
Massage Therapist
MT.0023181
CO
Other
Enumeration date
07/29/2020
Last updated
10/11/2024
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