ANTONIO PROVENCIO

AIEA, HI
NPI1821598699
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171100000X Acupuncturist
Additional Taxonomies171100000X Acupuncturist
225700000X Massage Therapist
Enumeration Date2018-02-17
Last Update Date2018-07-29
Business Address
ANTONIO PROVENCIO LAc
98-199 KAMEHAMEHA HWY STE F3
AIEA, HI 96701
Phone number: 808-364-1555
Mailing Address
ANTONIO PROVENCIO LAc
98-199 KAMEHAMEHA HWY STE F3
AIEA, HI 96701-4820
Phone number: 808-364-1555
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