MEDICARE: MRS. ERICA GIAO DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	6473	HI

General Provider Information

NPI Number	:	1457679326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERICA GIAO DAVIS

Provider Business Mailing Address
First Line	:	68-3557 MALINA ST
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5353
Country	:	US
Telephone Number	:	808-371-4877
Fax Number	:

Provider Business Practice Location Address
First Line	:	68-1845 WAIKOLOA RD
Second Line	:	UNIT 201 B
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5584
Country	:	US
Telephone Number	:	808-443-4770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2010
Last Update Date	:	05/17/2010

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