Individual
KEWALA TILLAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
66-387 PAALAA RD, HALEIWA, HI 96712-1437
(808) 429-9505
Mailing address
66-387 PAALAA RD, HALEIWA, HI 96712-1437
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-16856
HI
Other
Enumeration date
07/10/2022
Last updated
07/10/2022
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