Provider Demographics
NPI:1033538913
Name:STUART B. HAYTER
Entity Type:Organization
Organization Name:STUART B. HAYTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:HAYTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-938-4237
Mailing Address - Street 1:1365 KALANIANAOLE AVE
Mailing Address - Street 2:APT# 107
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4971
Mailing Address - Country:US
Mailing Address - Phone:808-938-4237
Mailing Address - Fax:
Practice Address - Street 1:1365 KALANIANAOLE AVE
Practice Address - Street 2:APT# 107
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4971
Practice Address - Country:US
Practice Address - Phone:808-938-4237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT#13162225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty