Healthcare Provider Details

I. General information

NPI: 1437645181
Provider Name (Legal Business Name): KEIKI THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64-957 MAMALAHOA HWY
KAMUELA HI
96743-8415
US

IV. Provider business mailing address

68-1849 PAU NANI ST
WAIKOLOA HI
96738-5441
US

V. Phone/Fax

Practice location:
  • Phone: 808-209-7934
  • Fax: 808-883-6262
Mailing address:
  • Phone: 808-747-4982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: NICOLE KORANDA
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 808-209-7934