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General NPI Number Information
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NPI Number | 1548645393
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Entity Type | Individual
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Provider Name | DIONISIO VINLUAN VELASQUEZ MASSAGE THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 2041-B NORTH KING ST.
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City | HONOLULU
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State | HI
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Zip | 96819-4218
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Country | US
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Telephone | 808-391-9585
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Fax | 808-841-0247
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Provider Business Mailing Address
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Address Line | 775 MCNEILL ST. #118-B
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City | HONOLULU
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State | HI
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Zip | 96817-4218
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Country | US
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Telephone | 808-391-9585
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Fax | 808-841-0247
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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-6126
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License Number State | HI
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