Healthcare Provider Details

I. General information

NPI: 1780712521
Provider Name (Legal Business Name): DREAMWALK CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 LAIMANA ST
HILO HI
96720-2542
US

IV. Provider business mailing address

41 LAIMANA ST
HILO HI
96720-2542
US

V. Phone/Fax

Practice location:
  • Phone: 808-969-3100
  • Fax: 808-935-3900
Mailing address:
  • Phone: 808-969-3100
  • Fax: 808-935-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. PHILIP CHONG
Title or Position: PRESIDENT-OWNER
Credential: CPO
Phone: 808-969-3100