MEDICARE: SYSTEM PHYSICAL THERAPY CORP.

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
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1942067236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYSTEM PHYSICAL THERAPY CORP.

Provider Business Mailing Address
First Line	:	4211 WAIALAE AVE STE 303
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5316
Country	:	US
Telephone Number	:	808-501-0201
Fax Number	:	808-888-0270

Provider Business Practice Location Address
First Line	:	4211 WAIALAE AVE STE 303
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5316
Country	:	US
Telephone Number	:	808-501-0201
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	JUNE MARIE SY
Credential	:	PT
Telephone Number	:	808-501-0201

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	10/19/2024

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Directions to “SYSTEM PHYSICAL THERAPY CORP. ” Practice Location

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