Individual
IVY R RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
95-720 LANIKUHANA AVE STE 140, MILILANI, HI 96789-2986
(808) 623-6244
(808) 623-6414
Mailing address
95-720 LANIKUHANA AVE STE 140, MILILANI, HI 96789-2986
(808) 623-6244
(808) 623-6414
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT 11318
HI
Other
Enumeration date
04/19/2011
Last updated
04/19/2011
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