Collen, Glen Andrew

Collen, Glen Andrew is an individual health care provider with primary practice located at 1051 Keolu Dr Enchanted Lakes Massage Clinic Suite 104, Kailua HI 96734. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Acupuncturist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Other Service Providers / Acupuncturist is his primary health care specialty. Collen, Glen Andrew can be contacted via phone (808) 262-6563.

Contact Information

Primary practice address
1051 Keolu Dr Enchanted Lakes Massage Clinic Suite 104 Kailua HI 96734
Phone: (808) 262-6563
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Acupuncturist 171100000X 579LAC Hawaii
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X LMT5268 Hawaii

Profile Details

NPI number 1275737520
LBN Legal business name Collen, Glen Andrew
Credentials LMT5268 LAC GC579
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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