Provider Demographics
NPI:1992272215
Name:ALPHA MEDICAL LOMI MASSAGE THERAPY LLC
Entity type:Organization
Organization Name:ALPHA MEDICAL LOMI MASSAGE THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MA JANNETTE
Authorized Official - Middle Name:RELAMPAGOS
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-652-1041
Mailing Address - Street 1:1936 HOKULEI PL
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-8969
Mailing Address - Country:US
Mailing Address - Phone:808-652-1041
Mailing Address - Fax:
Practice Address - Street 1:2970 KELE ST STE 112C
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1822
Practice Address - Country:US
Practice Address - Phone:808-652-1041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346758190OtherNPI NUMBER