Provider Demographics
NPI:1144759366
Name:ONO, DARYL TAKESHI (LMT)
Entity Type:Individual
Prefix:MR
First Name:DARYL
Middle Name:TAKESHI
Last Name:ONO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PONAHAWAI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3004
Mailing Address - Country:US
Mailing Address - Phone:808-935-5159
Mailing Address - Fax:
Practice Address - Street 1:118 PONAHAWAI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3004
Practice Address - Country:US
Practice Address - Phone:808-937-9926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5212225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist