Healthcare Provider Details

I. General information

NPI: 1346964129
Provider Name (Legal Business Name): KULEANA PHYSICAL THERAPY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66-210 KAMEHAMEHA HWY STE A
HALEIWA HI
96712-2408
US

IV. Provider business mailing address

66-210 KAMEHAMEHA HWY STE A
HALEIWA HI
96712-2408
US

V. Phone/Fax

Practice location:
  • Phone: 808-726-3837
  • Fax:
Mailing address:
  • Phone: 808-726-3837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JACQUELYN REISER
Title or Position: OWNER
Credential: DPT
Phone: 757-652-5275