Provider Demographics
NPI:1437255486
Name:MERRYMAN, MARGARET ANN (MT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:MERRYMAN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:HANAPEPE
Mailing Address - State:HI
Mailing Address - Zip Code:96716
Mailing Address - Country:US
Mailing Address - Phone:808-651-9916
Mailing Address - Fax:808-335-6423
Practice Address - Street 1:4353 WAIALO RD
Practice Address - Street 2:9B PORT ALLEN MARINA CENTER
Practice Address - City:ELEELE
Practice Address - State:HI
Practice Address - Zip Code:96702-0207
Practice Address - Country:US
Practice Address - Phone:808-335-5808
Practice Address - Fax:808-335-5657
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT8729225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist