Healthcare Provider Details

I. General information

NPI: 1861274037
Provider Name (Legal Business Name): PTX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 PENSACOLA ST STE C5
HONOLULU HI
96822-3878
US

IV. Provider business mailing address

1535 PENSACOLA ST STE C5
HONOLULU HI
96822-3878
US

V. Phone/Fax

Practice location:
  • Phone: 808-214-2478
  • Fax:
Mailing address:
  • Phone: 808-214-2478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRIAN D JONES
Title or Position: OWNER/PRACTITIONER
Credential: DPT
Phone: 808-214-2478