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General NPI Number Information
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NPI Number | 1003914193
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Entity Type | Individual
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Provider Name | DANIEL EDWARD RICK P.T.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 75-5699 KOPIKO ST
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City | KAILUA KONA
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State | HI
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Zip | 96740-1668
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Country | US
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Telephone | 808-329-7744
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Fax | 808-334-1608
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Provider Business Mailing Address
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Address Line | PO BOX 647
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City | CAPTAIN COOK
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State | HI
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Zip | 96704-0647
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Country | US
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Telephone | 808-323-3108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-699
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License Number State | HI
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