Healthcare Provider Details

I. General information

NPI: 1871900340
Provider Name (Legal Business Name): ACUFIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 KILAUEA AVE STE 213
HONOLULU HI
96816-5308
US

IV. Provider business mailing address

4119 PAHOA AVE
HONOLULU HI
96816-4638
US

V. Phone/Fax

Practice location:
  • Phone: 808-597-6203
  • Fax:
Mailing address:
  • Phone: 808-597-6203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1096
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13128
License Number StateHI

VIII. Authorized Official

Name: NICOLE KELLNER
Title or Position: OWNER
Credential:
Phone: 808-597-6203