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NPI 1548819790

NPI 1548819790 : LIVE PAIN FREE PT : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1548819790
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    Entity Type          |    Organization 
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    Legal Business Name  |    LIVE PAIN FREE PT 
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Dates
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    Enumeration Date     |    09/10/2019
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    Last Update Date     |    09/10/2019
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Provider Practice Location Address
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    Address Line         |    55 S JUDD ST APT 808 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96817-2608
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    Country              |    US
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    Telephone            |    808-368-2834
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    55 S JUDD ST APT 808 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96817-2608
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    Country              |    US
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    Telephone            |    808-368-2834
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DOCTOR OF PHYSICAL THERAPY
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    Name                 |     BRIAN D JONES 
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    Credential           |    DPT
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    Telephone            |    808-368-2834
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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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