Provider Demographics
NPI:1487014429
Name:SCOTT'S MASSAGE LLC
Entity Type:Organization
Organization Name:SCOTT'S MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:KAISER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-230-5097
Mailing Address - Street 1:3364 HARDING AVE
Mailing Address - Street 2:APT 9
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2445
Mailing Address - Country:US
Mailing Address - Phone:808-230-5097
Mailing Address - Fax:
Practice Address - Street 1:3364 HARDING AVE
Practice Address - Street 2:APT 9
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2445
Practice Address - Country:US
Practice Address - Phone:808-230-5097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty