Provider Demographics
NPI:1982266862
Name:MCCRARY, GILBERT LLOYD (LMT)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:LLOYD
Last Name:MCCRARY
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 1:2740 LIHOLANI ST UNIT 18
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8462
Mailing Address - Country:US
Mailing Address - Phone:808-283-6851
Mailing Address - Fax:
Practice Address - Street 1:2740 LIHOLANI ST UNIT 18
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8462
Practice Address - Country:US
Practice Address - Phone:808-283-6851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT6067225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist