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General NPI Number Information
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NPI Number | 1497232466
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Entity Type | Organization
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Legal Business Name | ISLAND HAND THERAPY CLINIC LLC
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 08/01/2018
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Provider Practice Location Address
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Address Line | 3175 ELUA ST STE A
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City | LIHUE
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State | HI
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Zip | 96766
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Country | US
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Telephone | 808-960-8245
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Fax |
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Provider Business Mailing Address
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Address Line | 3175 ELUA ST STE A
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City | LIHUE
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State | HI
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Zip | 96766-1203
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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 | BILLER
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Name | JOANNA DAVIS
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Credential |
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Telephone | 808-823-0103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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