Doctor Name: | MRS. ELLARENE KUULIEALOHA VOGELGESANG |
NPI Number: | 1528314267 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | MATT3913 |
Business Practice Address: | 74-5620 Palani Rd Ste 100 Kailua Kona, HI - 967403640 |
Business Phone Number: | 8083318860 |
Business Fax Number: | |
Mailing Address: | Po Box 4386, KAILUA KONA |
State: | HI |
Postal Code: | 967454386 |
Phone Number: | 8083157710 |
Fax Number: | |
NPI Enumeration Date: | 07/31/2012 |
NPI Last Update Date: | 07/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MATT3913 |
Healthcare Provider Taxonomy: (Secondary) | N |
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. |