Healthcare Provider Details

I. General information

NPI: 1770678252
Provider Name (Legal Business Name): SLR THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4603 ALIIKOA STREET
HONOLULU HI
96821
US

IV. Provider business mailing address

820 MILILANI STREET SUITE 702A
HONOLULU HI
96813
US

V. Phone/Fax

Practice location:
  • Phone: 808-732-4288
  • Fax: 808-732-4288
Mailing address:
  • Phone: 808-523-9363
  • Fax: 808-523-9418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 1930
License Number StateHI

VIII. Authorized Official

Name: ROBERT DAMIEN MAKIYA
Title or Position: PRESIDENT
Credential: PT
Phone: 808-732-4288