Provider Demographics
NPI:1851641708
Name:LANGENSTEIN, THOMAS (LMT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:LANGENSTEIN
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:PO BOX 1165
Mailing Address - Street 2:
Mailing Address - City:CAPTAIN COOK
Mailing Address - State:HI
Mailing Address - Zip Code:96704-1165
Mailing Address - Country:US
Mailing Address - Phone:808-323-3111
Mailing Address - Fax:
Practice Address - Street 1:82-6161 MAMALAHOA HWY.
Practice Address - Street 2:
Practice Address - City:CAPTAIN COOK,
Practice Address - State:HI
Practice Address - Zip Code:96704
Practice Address - Country:US
Practice Address - Phone:808-323-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-00927225700000X
HIMAE-305225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist