Provider Demographics
NPI:1710332317
Name:BARAD, MICHAEL (LMT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:BARAD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-1170 HOOKEHA ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1529
Mailing Address - Country:US
Mailing Address - Phone:808-753-0334
Mailing Address - Fax:
Practice Address - Street 1:92-1170 HOOKEHA ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1529
Practice Address - Country:US
Practice Address - Phone:808-753-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-14641225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist