Timothy Amor

Individual provider Active NPI Massage Therapist · Ewa Beach, HI

NPI 1164031498 · NPPES record last updated Jul 22, 2020

Key facts

NPI
1164031498
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MAT-16389 (HI)
Practice address
91-135 Wailohia PL
Ewa Beach, HI 96706-1854
Phone
(808) 931-9757
NPI assigned
Jul 22, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA-179HIMDOccupational Therapy Assistant
MAT-16389HIMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA-179 HI
Massage Therapist 225700000X MAT-16389 HI Yes

Addresses

Primary practice location

91-135 Wailohia PL
Ewa Beach, HI 96706-1854

Mailing address

91-135 Wailohia PL
Ewa Beach, HI 96706-1854
Phone (808) 931-9757

Other providers in Ewa Beach, HI

All providers in Ewa Beach, HI · Massage Therapist in Hawaii

Sources for this page

Verify at the official NPI Registry.