Healthcare Provider Details

I. General information

NPI: 1033879515
Provider Name (Legal Business Name): HARAGUCHI PHYSICAL THERAPY & ORTHOPEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2021
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 ALA NAMAHANA PKWY STE G1
KILAUEA HI
96754-5395
US

IV. Provider business mailing address

PO BOX 439
ANAHOLA HI
96703-0439
US

V. Phone/Fax

Practice location:
  • Phone: 808-639-5130
  • Fax:
Mailing address:
  • Phone: 808-639-5130
  • 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: DR. EMELIA LOREN HARAGUCHI
Title or Position: DOCTOR OF PHYSICAL THERAPY, CEO
Credential: PT, DPT, OCS
Phone: 808-639-5130