Healthcare Provider Details

I. General information

NPI: 1467529743
Provider Name (Legal Business Name): HEALTHCARE THERAPY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 N KING ST STE 101A
HONOLULU HI
96819-3470
US

IV. Provider business mailing address

2024 N KING ST STE 101A
HONOLULU HI
96819-3470
US

V. Phone/Fax

Practice location:
  • Phone: 808-843-1400
  • Fax:
Mailing address:
  • Phone: 808-843-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number10563660
License Number StateHI

VIII. Authorized Official

Name: KAREN SCOTT SCOTT
Title or Position: OFFICE MANAGER
Credential:
Phone: 808-398-2387