MS. Susan Ina Bohannon, MASSAGE THERAPIST

NPI #1366513418 in Wailuku, Hawaii

Provider Information

NPI Number: 1366513418
Entity Type: Individual
Name: MS. Susan Ina Bohannon, MASSAGE THERAPIST
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: MASSAGE THERAPIST
Enumeration Date: Nov 12, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 69 N CHURCH ST
City: Wailuku
State: Hawaii
ZIP Code: 96793-1611
Phone: (808) 244-1164

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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