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General NPI Number Information
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NPI Number | 1023483989
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Entity Type | Organization
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Legal Business Name | OHANA HEALING CENTER, LLC
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 1481 S KING ST SUITE 321
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City | HONOLULU
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State | HI
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Zip | 96814-2601
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Country | US
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Telephone | 808-944-0088
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Fax | 808-482-2057
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Provider Business Mailing Address
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Address Line | 1481 S KING ST SUITE 321
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City | HONOLULU
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State | HI
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Zip | 96814-2601
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Country | US
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Telephone | 808-944-0088
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Fax | 808-482-2057
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Authorized Official
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Title or Position | PRINCIPLE MASSAGE THERAPIST
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Name | MRS. HEE KYONG TONG
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Credential | MASSAGE THERAPIST
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Telephone | 808-944-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MAT 14495
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License Number State | HI
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