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General NPI Number Information
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NPI Number | 1639032089
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Entity Type | Individual
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Provider Name | JORDAN ANTHONY KAUIOKALANI GENOVIA DPT, BS
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Gender | Male
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 98-211 PALI MOMI ST STE 300
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City | AIEA
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State | HI
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Zip | 96701-4318
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Country | US
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Telephone | 808-456-5888
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Fax | 808-455-6936
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Provider Business Mailing Address
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Address Line | 98-211 PALI MOMI ST STE 300
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City | AIEA
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State | HI
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Zip | 96701-4318
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Country | US
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Telephone | 808-456-5888
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Fax | 808-455-6936
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6223
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License Number State | HI
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