Individual
DIANE JEAN VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75-166 KALANI ST, 203, KAILUA KONA, HI 96740-1857
(808) 329-5155
Mailing address
PO BOX 390285, KEAUHOU, HI 96739-0285
(808) 854-7306
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11338
HI
Other
Enumeration date
07/10/2009
Last updated
07/10/2009
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