Healthcare Provider Details

I. General information

NPI: 1659820967
Provider Name (Legal Business Name): BROOKE HOFFMAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 KALANIANAOLE HWY STE 207
HONOLULU HI
96825-1279
US

IV. Provider business mailing address

6700 KALANIANAOLE HWY STE 207
HONOLULU HI
96825-1279
US

V. Phone/Fax

Practice location:
  • Phone: 808-275-7087
  • Fax:
Mailing address:
  • Phone: 808-275-7087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number14570
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: