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General NPI Number Information
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NPI Number | 1972624419
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Entity Type | Organization
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Legal Business Name | MALAMA PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 95-229 HALEPULE PL
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City | MILILANI
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State | HI
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Zip | 96789-6579
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Country | US
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Telephone | 808-779-5623
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Fax | 808-440-7274
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Provider Business Mailing Address
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Address Line | 95-229 HALEPULE PL
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City | MILILANI
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State | HI
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Zip | 96789-6579
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Country | US
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Telephone | 808-779-5623
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Fax |
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Authorized Official
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Title or Position | OWNER MANAGER
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Name | ANNE YEE
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Credential | MSPT
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Telephone | 808-779-5623
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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 | PT 2246
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License Number State | HI
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