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General NPI Number Information
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NPI Number | 1124451497
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Entity Type | Individual
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Provider Name | LAURA FILTER PTA
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Gender | Female
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 380 HUKU LII PL SUITE 105
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City | KIHEI
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State | HI
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Zip | 96753-7043
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Country | US
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Telephone | 612-242-6320
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 791989
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City | PAIA
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State | HI
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Zip | 96779-1989
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Country | US
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Telephone | 612-242-6320
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | AT9839
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License Number State | CA
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