Doctor Name: | MISS LISA M GAGNON |
NPI Number: | 1598099434 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 8003 |
Business Practice Address: | 2114 Church St Iao Acupuncture & Spa Wailuku, HI - 96793 |
Business Phone Number: | 8082498280 |
Business Fax Number: | 8082498947 |
Mailing Address: | P.o. Box 790733, PAIA |
State: | HI |
Postal Code: | 96779 |
Phone Number: | 8082503809 |
Fax Number: | |
NPI Enumeration Date: | 09/24/2009 |
NPI Last Update Date: | 09/24/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 8003 |
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. |