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General NPI Number Information
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NPI Number | 1205759453
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Entity Type | Organization
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Legal Business Name | DETOX MASSAGE & STRETCH THERAPY LLC
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 98-029 HEKAHA ST STE 40
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City | AIEA
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State | HI
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Zip | 96701-4918
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Country | US
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Telephone | 808-590-4401
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Fax |
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Provider Business Mailing Address
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Address Line | 1822 KAUMUALII ST
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City | HONOLULU
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State | HI
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Zip | 96819-4042
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Country | US
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Telephone | 808-590-4401
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Fax |
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Authorized Official
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Title or Position | OWNER/MEM
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Name | JODI SYLVA
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Credential | LMT
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Telephone | 808-707-9177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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