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Michael Tanner Wagner
Massage Therapist in Haiku, Hawaii
NPI 1063272532

Michael Tanner Wagner is a Massage Therapist based in Kula, HI. Michael Tanner Wagner practices in Haiku, HI. The NPI Number for Michael Tanner Wagner is 1063272532 and holds a License No. MAT-12842 (Hawaii).

The current practice location address for Michael Tanner Wagner is 718 Haiku Rd, Haiku, HI and can be reached out via phone at 435-669-5171.

Location: 718 Haiku Rd, Haiku, HI, 96790-8015
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063272532
Provider Name
Michael Tanner Wagner
Credential
Provider Entity Type
Individual
Gender
Male
Address
718 Haiku Rd, Haiku, HI, 96790-8015
Phone Number
435-669-5171
Fax Number
Provider Enumeration Date
03/20/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
718 Haiku Rd
City
Haiku
State
Hawaii
Zip
96708-5846
Phone Number
435-669-5171
Fax Number
person
Provider Business Mailing Address Details
Address
718 Haiku Rd
City
Haiku
State
Hawaii
Zip
96708-5846
Phone Number
435-669-5171
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MAT-12842 (Hawaii)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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