Healthcare Provider Details

I. General information

NPI: 1487303871
Provider Name (Legal Business Name): SKYLER JONATHON HILDEN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-801 FARRINGTON HWY
WAIPAHU HI
96797-3164
US

IV. Provider business mailing address

94-801 FARRINGTON HWY
WAIPAHU HI
96797-3164
US

V. Phone/Fax

Practice location:
  • Phone: 808-680-9123
  • Fax:
Mailing address:
  • Phone: 808-680-9123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT-5396-0
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT-5396-0
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-5396-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: