Provider Demographics
NPI:1750902839
Name:MASSAGE THERAPY AND WELLNESS OF HAWAI, LLC
Entity type:Organization
Organization Name:MASSAGE THERAPY AND WELLNESS OF HAWAI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:DELOS SANTOS
Authorized Official - Last Name:TECSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-276-3130
Mailing Address - Street 1:312 PUUMAKANI PL
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3144
Mailing Address - Country:US
Mailing Address - Phone:808-276-3130
Mailing Address - Fax:808-871-6005
Practice Address - Street 1:MASSAGE THERAPY AND WELLNESS OF HAWAII
Practice Address - Street 2:219 HOOKAHI ST SUITE 108
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:808-666-3256
Practice Address - Fax:808-871-6005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty