Healthcare Provider Details

I. General information

NPI: 1114287752
Provider Name (Legal Business Name): SARAH RHINELANDER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 05/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7701 KOOLAU RD
KILAUEA HI
96754-5564
US

IV. Provider business mailing address

PO BOX 716
ANAHOLA HI
96703-0716
US

V. Phone/Fax

Practice location:
  • Phone: 808-927-1707
  • Fax:
Mailing address:
  • Phone: 808-927-1707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number10058
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: