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General NPI Number Information
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NPI Number | 1831376383
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Entity Type | Organization
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Legal Business Name | BALANCE CENTERS OF THE PACIFIC, INC
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 02/10/2008
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Provider Practice Location Address
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Address Line | 600 KAPIOLANI BLVD STE 404
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City | HONOLULU
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State | HI
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Zip | 96813-5141
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Country | US
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Telephone | 808-955-8339
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Fax | 808-955-9808
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Provider Business Mailing Address
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Address Line | 600 KAPIOLANI BLVD STE 404
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City | HONOLULU
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State | HI
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Zip | 96813-5141
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Country | US
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Telephone | 808-955-8339
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Fax | 808-955-9808
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT F KISSENBERGER
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Credential | DPT
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Telephone | 808-955-8339
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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 | 2078
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License Number State | HI
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