MEDICARE: THERAPEUTIC CONNECTION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1558144626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC CONNECTION

Provider Business Mailing Address
First Line	:	PO BOX 383226
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-3226
Country	:	US
Telephone Number	:	808-731-6996
Fax Number	:	808-731-6997

Provider Business Practice Location Address
First Line	:	68-1873 PANIOLO PL
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5222
Country	:	US
Telephone Number	:	808-938-7084
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CAROLYN SILAN
Credential	:	PT
Telephone Number	:	808-938-7084

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	05/17/2024

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Directions to “THERAPEUTIC CONNECTION ” Practice Location

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