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General NPI Number Information
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NPI Number | 1689879462
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Entity Type | Organization
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Legal Business Name | OHANA PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 81 CENTRAL AVE
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City | WAILUKU
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State | HI
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Zip | 96793-1723
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Country | US
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Telephone | 808-244-6878
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Fax |
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Provider Business Mailing Address
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Address Line | 29 PUUKAI PL
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City | KAHULUI
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State | HI
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Zip | 96732-3208
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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 | PRESIDENT
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Name | ROSWITHA E GABRIEL
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Credential |
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Telephone | 808-244-6878
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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 | PT-703
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License Number State | HI
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