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General NPI Number Information
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NPI Number | 1629684063
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Entity Type | Individual
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Provider Name | STERLING CORIA
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Gender | Male
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 354 ULUNIU ST
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City | KAILUA
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State | HI
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Zip | 96734-2528
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Country | US
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Telephone | 808-800-7369
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Fax |
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Provider Business Mailing Address
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Address Line | 354 ULUNIU ST STE 404A
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City | KAILUA
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State | HI
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Zip | 96734-2533
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Country | US
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Telephone | 808-800-7369
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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 | 13723
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License Number State | HI
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