Healthcare Provider Details

I. General information

NPI: 1902831498
Provider Name (Legal Business Name): MILILANI PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95-720 LANIKUHANA AVE 140
MILILANI HI
96789-2985
US

IV. Provider business mailing address

95-720 LANIKUHANA AVE 140
MILILANI HI
96789-2985
US

V. Phone/Fax

Practice location:
  • Phone: 808-623-6244
  • Fax: 808-623-6414
Mailing address:
  • Phone: 808-623-6244
  • Fax: 808-623-6414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARY LAU-MIKI
Title or Position: DIRECTOR
Credential:
Phone: 808-623-6244