Healthcare Provider Details

I. General information

NPI: 1619960275
Provider Name (Legal Business Name): THPT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 W HIND DR SUITE 201
HONOLULU HI
96821-1855
US

IV. Provider business mailing address

850 W HIND DR SUITE 201
HONOLULU HI
96821-1855
US

V. Phone/Fax

Practice location:
  • Phone: 808-377-5605
  • Fax: 808-377-5604
Mailing address:
  • Phone: 808-377-5605
  • Fax: 808-377-5604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT979
License Number StateHI

VIII. Authorized Official

Name: MR. THOMAS J HARRER
Title or Position: CEO
Credential: PT
Phone: 808-377-5605