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NPI Code Detail

MEDICARE: PRIME PT WELLNESS CLINIC

MEDICARE: PRIME PT WELLNESS CLINIC
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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1427681204
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIME PT WELLNESS CLINIC
Provider Business Mailing Address
First Line : 45-955 KAMEHAMEHA HWY STE 300
Second Line :
City : KANEOHE
State : HI
Zip : 96744-3292
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 45-955 KAMEHAMEHA HWY STE 300
Second Line :
City : KANEOHE
State : HI
Zip : 96744-3292
Country : US
Telephone Number : 808-379-0031
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. KAI MORIGAWARA
Credential : PT, DPT
Telephone Number : 808-379-0031
Provider Enumeration Date : 02/19/2020
Last Update Date : 02/19/2020

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Directions to “PRIME PT WELLNESS CLINIC ” Practice Location

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