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General NPI Number Information
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NPI Number | 1164327128
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Entity Type | Individual
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Provider Name | LAWRENCE REYNOLDS LMT
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Gender | Male
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Dates
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Enumeration Date | 10/10/2026
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Last Update Date | 10/10/2026
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Provider Practice Location Address
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Address Line | 224 KAMEHAMEHA AVE STE 206
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City | HILO
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State | HI
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Zip | 96720-2878
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Country | US
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Telephone | 808-747-7415
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 266
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City | MOUNTAIN VIEW
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State | HI
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Zip | 96771-0266
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Country | US
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Telephone | 808-747-7415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MAT-15265
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License Number State | HI
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