Provider Demographics
NPI:1275401069
Name:MONTOYA, JOEL
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 L. HONOAPIILANI RD
Mailing Address - Street 2:F113
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761
Mailing Address - Country:US
Mailing Address - Phone:808-276-4336
Mailing Address - Fax:
Practice Address - Street 1:10 HOOHUI RD STE 107
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-9257
Practice Address - Country:US
Practice Address - Phone:808-276-4336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-24
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-13547225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist