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General NPI Number Information
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NPI Number | 1558843847
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Entity Type | Organization
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Legal Business Name | INVICTUS REHAB & WELLNESS
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Dates
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Enumeration Date | 09/03/2018
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Last Update Date | 09/03/2018
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Provider Practice Location Address
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Address Line | 725 KAPIOLANI BLVD STE C103
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City | HONOLULU
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State | HI
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Zip | 96813-6027
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Country | US
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Telephone | 808-778-6832
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Fax | 808-356-0655
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Provider Business Mailing Address
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Address Line | PO BOX 25685
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City | HONOLULU
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State | HI
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Zip | 96825-0685
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Country | US
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Telephone | 808-778-6832
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Fax | 808-356-0655
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY JAMES LETTERII
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Credential |
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Telephone | 808-778-6832
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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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