Individual
BRENNA MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
77-6537 NANILOA DR, KAILUA KONA, HI 96740-2425
(808) 896-3513
Mailing address
PO BOX 1649, KEALAKEKUA, HI 96750-1649
(808) 896-3513
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11256
HI
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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