Healthcare Provider Details

I. General information

NPI: 1225366545
Provider Name (Legal Business Name): AMC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 HANA HWY SUITE 6
PAIA HI
96779-9745
US

IV. Provider business mailing address

PO BOX 791954
PAIA HI
96779-1954
US

V. Phone/Fax

Practice location:
  • Phone: 808-579-9750
  • Fax: 808-579-9751
Mailing address:
  • Phone: 808-579-9750
  • Fax: 808-579-9751

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: AMBER PANEBIANCO
Title or Position: PRESIDENT, PHYSICAL THERAPIST
Credential: MPT
Phone: 808-579-9750