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General NPI Number Information
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NPI Number | 1962656553
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Entity Type | Organization
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Legal Business Name | FIT THERAPY LLC
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Dates
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Enumeration Date | 11/09/2008
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Last Update Date | 11/09/2008
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Provider Practice Location Address
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Address Line | 615 HIND IUKA DR APT C
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City | HONOLULU
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State | HI
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Zip | 96821-1773
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Country | US
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Telephone | 808-398-3357
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Fax | 866-359-9526
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Provider Business Mailing Address
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Address Line | PO BOX 240794
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City | HONOLULU
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State | HI
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Zip | 96824-0794
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Country | US
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Telephone | 808-398-3357
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Fax | 866-359-9526
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Authorized Official
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Title or Position | MEMBER, PHYSICAL THERAPIST
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Name | MS. ELIZABETH ANN FRYE
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Credential | PT, DPT, CERT. MDT
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Telephone | 808-398-3357
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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 | 2011
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License Number State | HI
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