Provider Demographics
NPI:1417579343
Name:BIG ISLAND MASSAGE NETWORK LLC
Entity Type:Organization
Organization Name:BIG ISLAND MASSAGE NETWORK LLC
Other - Org Name:BIG ISLAND MASSAGE NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:TUFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-557-8807
Mailing Address - Street 1:12-7004 HOKUAO ST # 50
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-7892
Mailing Address - Country:US
Mailing Address - Phone:808-557-8807
Mailing Address - Fax:844-781-8303
Practice Address - Street 1:12-7002 HOKUAO ST # 4693
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-7892
Practice Address - Country:US
Practice Address - Phone:808-965-9787
Practice Address - Fax:844-781-8303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty