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General NPI Number Information
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NPI Number | 1508205402
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC CONCEPTS, LLC
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 07/03/2013
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Provider Practice Location Address
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Address Line | 1714 ANAPUNI ST 301
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City | HONOLULU
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State | HI
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Zip | 96822-4482
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Country | US
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Telephone | 808-348-7747
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Fax | 808-356-0888
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Provider Business Mailing Address
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Address Line | 1714 ANAPUNI ST 301
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City | HONOLULU
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State | HI
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Zip | 96822-4482
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Country | US
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Telephone | 808-348-7747
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Fax | 808-356-0888
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Authorized Official
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Title or Position | MEMBER
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Name | TARA TANNENHOLZ
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Credential | PT
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Telephone | 808-348-7747
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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 | 2468
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License Number State | HI
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