Healthcare Provider Details

I. General information

NPI: 1407546427
Provider Name (Legal Business Name): ALICIA WRIGHT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA TAYLOR DPT

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 KEAWE ST STE 102
HONOLULU HI
96813-5997
US

IV. Provider business mailing address

400 KEAWE ST STE 102
HONOLULU HI
96813-5997
US

V. Phone/Fax

Practice location:
  • Phone: 808-208-8822
  • Fax: 808-373-3666
Mailing address:
  • Phone: 808-208-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-5664-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: