Individual
WICHAI PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
26 HOOLAI ST STE 600, KAILUA, HI 96734-6110
(949) 627-5426
Mailing address
746 MCCULLY ST APT G, HONOLULU, HI 96826-3909
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT17184
HI
Other
Enumeration date
07/31/2025
Last updated
07/31/2025
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