Provider Demographics
NPI:1194038687
Name:THE COCONUT GIRLS.COM LLC
Entity Type:Organization
Organization Name:THE COCONUT GIRLS.COM LLC
Other - Org Name:COCONUT GIRLS MASSAG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEON
Authorized Official - Suffix:
Authorized Official - Credentials:MAT
Authorized Official - Phone:808-937-2515
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:HOLUALOA
Mailing Address - State:HI
Mailing Address - Zip Code:96725-0010
Mailing Address - Country:US
Mailing Address - Phone:808-937-2515
Mailing Address - Fax:
Practice Address - Street 1:74-5583 LUHIA ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3624
Practice Address - Country:US
Practice Address - Phone:808-937-2515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2288172M00000X
HI4642173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Single Specialty