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General NPI Number Information
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NPI Number | 1962213991
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Entity Type | Organization
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Legal Business Name | MARISSA DANNAWAY PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 555 UNIVERSITY AVE APT 103
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City | HONOLULU
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State | HI
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Zip | 96826-5018
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Country | US
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Telephone | 808-286-7853
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 61243
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City | HONOLULU
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State | HI
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Zip | 96839-1243
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Country | US
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Telephone | 808-674-7753
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MARISSA DANNAWAY
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Credential | PT, DPT
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Telephone | 808-286-7853
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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 |
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License Number State |
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