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General NPI Number Information
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NPI Number | 1205206083
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Entity Type | Individual
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Provider Name | DANA DUNCAN
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Gender | Female
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 10/06/2015
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Provider Practice Location Address
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Address Line | 3681 BALDWIN AVE
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City | MAKAWAO
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State | HI
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Zip | 96768-7505
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Country | US
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Telephone | 860-581-0071
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 540
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City | HAIKU
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State | HI
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Zip | 96708-0540
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Country | US
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Telephone | 860-581-0071
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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 | 14233
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License Number State | HI
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