Individual
MRS. DONNALYN L MEDEIROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1437 KILAUEA AVE STE 103, HILO, HI 96720-4200
(808) 498-4160
(808) 498-4163
Mailing address
1437 KILAUEA AVE STE 103, HILO, HI 96720-4200
(808) 498-4160
(808) 498-4163
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT2819
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MAT2819
LICENSE MASSAGE THERAPIST
HI
Enumeration date
05/06/2014
Last updated
05/06/2014
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