Individual
NIV HEMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
59-523 PUPUKEA RD, HALEIWA, HI 96712-9608
(808) 590-7068
Mailing address
PO BOX 235212, HONOLULU, HI 96823-3503
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-11275
HI
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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