Organization Name: | GREEN TI BOUTIQUE AND MASSAGE LLC |
NPI Number: | 1801237045 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ERICA LYNN OLEKSA (OWNER/MANAGER) |
Mailing Address: | 40 N Market St Wailuku |
State: | HI US |
Postal Code: | 967931718 |
Phone Number: | 8082428788 |
Fax Number: | 8082428788 |
NPI Enumeration Date: | 07/16/2013 |
NPI Last Update Date: | 07/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 2281 |
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. |