Individual
RANDALL SCOTT WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2421 ALA WAI BLVD, HONOLULU, HI 96815-3452
(510) 709-9646
Mailing address
2421 ALA WAI BOULEVARD 602, HONOLULU, HI 96815
(510) 709-9646
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12755
HI
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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