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General NPI Number Information
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NPI Number | 1215470323
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Entity Type | Organization
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Legal Business Name | WATER LILY FLOAT SPA, LLC
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 11/21/2016
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Provider Practice Location Address
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Address Line | 320 WARD AVENUE
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City | HONOLULU
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State | HI
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Zip | 96814
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Country | US
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Telephone | 808-675-8399
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Fax |
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Provider Business Mailing Address
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Address Line | 320 WARD AVE
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City | HONOLULU
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State | HI
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Zip | 96814-4001
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Country | US
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Telephone | 808-675-8399
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LILY LEUNG CAUSIN
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Credential | LAC
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Telephone | 808-683-6007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU-1086
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License Number State | HI
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