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General NPI Number Information
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NPI Number | 1285306589
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Entity Type | Organization
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Legal Business Name | PROXIMAL PHYSICAL THERAPY AND WELLNESS LLC
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 15-2984 PAHOA VILLAGE RD
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City | PAHOA
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State | HI
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Zip | 96778
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Country | US
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Telephone | 808-796-3310
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Fax | 808-796-3309
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Provider Business Mailing Address
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Address Line | PO BOX 492907
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City | KEAAU
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State | HI
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Zip | 96749-2907
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | STAFF PT
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Name | MARC SAGUIGUIT
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Credential | PT
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Telephone | 808-796-3310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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