Provider Demographics
NPI:1164201158
Name:THAI AROMA MASSAGE THERAPY LLC
Entity Type:Organization
Organization Name:THAI AROMA MASSAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATHAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-478-2661
Mailing Address - Street 1:563 FARRINGTON HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2031
Mailing Address - Country:US
Mailing Address - Phone:808-478-2661
Mailing Address - Fax:
Practice Address - Street 1:563 FARRINGTON HWY STE 202
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2031
Practice Address - Country:US
Practice Address - Phone:808-478-2661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty