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General NPI Number Information
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NPI Number | 1700018983
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Entity Type | Organization
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Legal Business Name | LIVING YOUNG LLC
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 07/20/2012
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Provider Practice Location Address
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Address Line | 3465 WAIALAE AVE STE 101
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City | HONOLULU
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State | HI
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Zip | 96816-2638
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Country | US
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Telephone | 808-224-5747
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Fax |
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Provider Business Mailing Address
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Address Line | 3703 PELU PL
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City | HONOLULU
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State | HI
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Zip | 96816-3811
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Country | US
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Telephone | 808-224-5747
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MS. KRIS CHUN
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Credential | LMT
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Telephone | 808-224-5747
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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-2430
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License Number State | HI
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