Doctor Name: | MS. SANDRA LEE CLEGG |
NPI Number: | 1114054251 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T. |
License Number: | 2300 |
Business Practice Address: | 4747 Kilauea Ave Ste. 115 Honolulu, HI - 968165308 |
Business Phone Number: | 8085421192 |
Business Fax Number: | 8087353503 |
Mailing Address: | 59-821 Kamehameha Hwy, HALEIWA |
State: | HI |
Postal Code: | 967129407 |
Phone Number: | 8085421192 |
Fax Number: | 8087353503 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 2300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |