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General NPI Number Information
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NPI Number | 1972483519
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Entity Type | Organization
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Legal Business Name | RELAX & REVIVE MASSAGE LLC
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 3191 TOMICH CT
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City | HONOLULU
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State | HI
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Zip | 96818-3334
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Country | US
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Telephone | 808-280-4865
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Fax |
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Provider Business Mailing Address
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Address Line | 3191 TOMICH CT
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City | HONOLULU
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State | HI
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Zip | 96818-3334
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | ALICIA JEAN VINCENT
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Credential | LMT
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Telephone | 808-280-4865
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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 |
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License Number State |
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