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General NPI Number Information
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NPI Number | 1700816980
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Entity Type | Organization
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Legal Business Name | QUALITY CARE THERAPY, LLC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 650 IWILEI RD SUITE 265
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City | HONOLULU
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State | HI
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Zip | 96817-5086
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Country | US
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Telephone | 808-550-4774
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Fax | 808-550-0097
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Provider Business Mailing Address
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Address Line | 650 IWILEI RD SUITE 265
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City | HONOLULU
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State | HI
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Zip | 96817-5086
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Country | US
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Telephone | 808-550-4774
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Fax | 808-550-0097
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Authorized Official
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Title or Position | OWNER
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Name | JULIE S.O. MOON
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Credential | PT
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Telephone | 808-550-4774
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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 | PT 1843
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License Number State | HI
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