Individual
STACY JACKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
35 KAHOPE ST, HAIKU, HI 96708
(808) 227-6112
Mailing address
35 KAHOPE ST, HAIKU, HI 96708
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT -11365
HI
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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