Healthcare Provider Details

I. General information

NPI: 1679643464
Provider Name (Legal Business Name): ALOHA WELLNESS CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1247 KAAHUMANU ST 109B
AIEA HI
96701-5311
US

IV. Provider business mailing address

98-1247 KAAHUMANU ST 109B
AIEA HI
96701-5311
US

V. Phone/Fax

Practice location:
  • Phone: 808-484-9106
  • Fax:
Mailing address:
  • Phone: 808-484-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT2010
License Number StateHI

VIII. Authorized Official

Name: ALMA BERSAMIN
Title or Position: OWNER
Credential:
Phone: 808-484-9106