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General NPI Number Information
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NPI Number | 1881593606
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Entity Type | Organization
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Legal Business Name | MANA EXERCISE THERAPY CENTER LLC
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 4929 POOLA ST UNIT A
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City | HONOLULU
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State | HI
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Zip | 96821-1443
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Country | US
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Telephone | 760-402-1561
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Fax |
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Provider Business Mailing Address
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Address Line | 4929 POOLA ST UNIT A
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City | HONOLULU
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State | HI
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Zip | 96821-1443
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Country | US
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Telephone | 760-402-1561
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JADON NEUENDORF
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Credential | MD
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Telephone | 760-402-1561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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