Healthcare Provider Details

I. General information

NPI: 1699796425
Provider Name (Legal Business Name): CURT K WATANABE D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 KAMEHAMEHA HWY SUITE 167C
PEARL CITY HI
96782-2656
US

IV. Provider business mailing address

850 KAMEHAMEHA HWY SUITE 167C
PEARL CITY HI
96782-2656
US

V. Phone/Fax

Practice location:
  • Phone: 808-454-2285
  • Fax: 808-454-1334
Mailing address:
  • Phone: 808-454-2285
  • Fax: 808-454-1334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number972
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: