Provider Demographics
NPI:1225154909
Name:RUPPENTHAL, WENDY STROH (LAC,LMT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:STROH
Last Name:RUPPENTHAL
Suffix:
Gender:F
Credentials:LAC,LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 KULOLIO PL
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5155
Mailing Address - Country:US
Mailing Address - Phone:808-280-9991
Mailing Address - Fax:
Practice Address - Street 1:212 KULOLIO PL
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708
Practice Address - Country:US
Practice Address - Phone:808-280-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI744171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist