Healthcare Provider Details

I. General information

NPI: 1952905796
Provider Name (Legal Business Name): SUMMER REYNOLDS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2020
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD STE 1113
HONOLULU HI
96814-4406
US

IV. Provider business mailing address

1350 SAINT LOUIS DR
HONOLULU HI
96816-1724
US

V. Phone/Fax

Practice location:
  • Phone: 415-225-0114
  • Fax:
Mailing address:
  • Phone: 415-225-0114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: