Healthcare Provider Details

I. General information

NPI: 1124033543
Provider Name (Legal Business Name): STEVE T NAKAMURA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4381 KUKUI GROVE ST STE 3
LIHUE HI
96766
US

IV. Provider business mailing address

4381 KUKUI GROVE ST STE 3
LIHUE HI
96766
US

V. Phone/Fax

Practice location:
  • Phone: 808-246-0144
  • Fax: 808-245-5148
Mailing address:
  • Phone: 808-246-0144
  • Fax: 808-245-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: