Individual
KIMBERLY MIKLAS VANT GROENEWOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
29 KAWEO PL, KULA, HI 96790-7939
(808) 283-9194
Mailing address
29 KAWEO PL, KULA, HI 96790-7939
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAT-3885
HI
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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