Healthcare Provider Details

I. General information

NPI: 1235395070
Provider Name (Legal Business Name): TROPICS ISLAND THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4353 WAIALO ROAD SUITE 5B
ELEELE HI
96705-0948
US

IV. Provider business mailing address

P.O. BOX 625
ELEELE HI
96705
US

V. Phone/Fax

Practice location:
  • Phone: 808-335-2790
  • Fax: 808-335-2792
Mailing address:
  • Phone: 808-335-2790
  • Fax: 808-335-2792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAE 2299
License Number StateHI

VIII. Authorized Official

Name: MR. DONALD KOEPFGEN
Title or Position: OWNER
Credential:
Phone: 808-335-2790