Martin Scott Wallace, LMT

NPI #1821844598 in Waikoloa, Hawaii

Provider Information

NPI Number: 1821844598
Entity Type: Individual
Name: Martin Scott Wallace, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Apr 24, 2024
Last Updated: Apr 24, 2024

Practice Location

Address: 68-3840 LUA KULA ST
Address 2: ADMIN 3
City: Waikoloa
State: Hawaii
ZIP Code: 96738
Phone: (808) 909-3111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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