Healthcare Provider Details

I. General information

NPI: 1366469082
Provider Name (Legal Business Name): HOZAKI PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 WILI PA LOOP STE 102 B
WAILUKU HI
96793-1278
US

IV. Provider business mailing address

1721 WILI PA LOOP STE 102 B
WAILUKU HI
96793-1278
US

V. Phone/Fax

Practice location:
  • Phone: 808-249-8384
  • Fax:
Mailing address:
  • Phone: 808-249-8384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number896
License Number StateHI

VIII. Authorized Official

Name: MR. BRIAN HARUO HOZAKI
Title or Position: PRESIDENT
Credential: P.T.
Phone: 808-281-0618