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General NPI Number Information
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NPI Number | 1700754512
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Entity Type | Individual
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Provider Name | MATTHEW GUBLER LMT
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Gender | Male
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 3681 BALDWIN AVE
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City | MAKAWAO
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State | HI
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Zip | 96768-7505
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Country | US
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Telephone | 808-357-9905
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Fax |
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Provider Business Mailing Address
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Address Line | 2455 KOKOMO RD
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City | HAIKU
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State | HI
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Zip | 96708-6068
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Country | US
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Telephone | 808-357-9905
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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 | 16379
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License Number State | HI
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