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General NPI Number Information
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NPI Number | 1811351125
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Entity Type | Individual
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Provider Name | MS. SALLY MICHELLE KIPPS
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Gender | Female
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 2230 LILIHA ST STE 500
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City | HONOLULU
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State | HI
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Zip | 96817-1646
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Country | US
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Telephone | 808-547-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 3121 PUALEI CIR APT 21
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City | HONOLULU
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State | HI
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Zip | 96815-4923
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Country | US
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Telephone | 971-322-6095
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Fax |
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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 | PT4113
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License Number State | HI
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