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General NPI Number Information
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NPI Number | 1205515087
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Entity Type | Organization
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Legal Business Name | CORE PHYSICAL THERAPY OF MAUI
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Dates
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Enumeration Date | 07/18/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 1817 WELLS ST
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City | WAILUKU
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State | HI
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Zip | 96793-2333
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Country | US
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Telephone | 808-757-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 23 KEONELOA ST
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City | WAILUKU
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State | HI
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Zip | 96793-2445
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Country | US
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Telephone | 808-269-7776
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KARLA KN KUROKAWA
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Credential | DPT
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Telephone | 808-269-7776
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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