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General NPI Number Information
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NPI Number | 1992029839
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Entity Type | Individual
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Provider Name | KELEN RAE GELLER CASEY LMT
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Gender | Female
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Dates
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Enumeration Date | 03/22/2010
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 65-1235A OPELO RD # 3
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City | KAMUELA
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State | HI
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Zip | 96743-8401
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Country | US
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Telephone | 808-885-8836
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Fax | 808-443-0265
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Provider Business Mailing Address
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Address Line | 65-1235A OPELO RD # 3
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City | KAMUELA
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State | HI
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Zip | 96743-8401
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Country | US
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Telephone | 808-885-8836
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Fax | 808-443-0265
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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 | 2935
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License Number State | HI
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