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General NPI Number Information
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NPI Number | 1093766610
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Entity Type | Individual
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Provider Name | ANGELA M. PETERS MPT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 135 S WAKEA AVE STE 112
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City | KAHULUI
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State | HI
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Zip | 96732-1385
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Country | US
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Telephone | 808-280-7711
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Fax | 808-442-0690
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Provider Business Mailing Address
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Address Line | PO BOX 790826
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City | PAIA
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State | HI
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Zip | 96779-0826
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Country | US
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Telephone | 808-280-7711
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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 | 2575
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License Number State | HI
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