Provider Demographics
NPI:1295345742
Name:LOMI HANAMANA LLC
Entity type:Organization
Organization Name:LOMI HANAMANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:GELERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-214-5054
Mailing Address - Street 1:30 E LIPOA ST UNIT 4107
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-5821
Mailing Address - Country:US
Mailing Address - Phone:808-214-5054
Mailing Address - Fax:
Practice Address - Street 1:30 E LIPOA ST UNIT 4107
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-5821
Practice Address - Country:US
Practice Address - Phone:808-214-5054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty