MEDICARE: INTEGRAL REHAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1083652457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRAL REHAB LLC

Provider Business Mailing Address
First Line	:	7018 HAWAII KAI DR
Second Line	:	#109
City	:	HONOLULU
State	:	HI
Zip	:	96825-4150
Country	:	US
Telephone Number	:	808-387-4995
Fax Number	:	808-395-5828

Provider Business Practice Location Address
First Line	:	1481 S KING ST STE 224
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-2602
Country	:	US
Telephone Number	:	808-387-4995
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MRS. JANA NOELLE KAY
Credential	:	MPT
Telephone Number	:	808-387-4995

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	01/31/2009

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