MEDICARE: CAROLYN JEAN SILAN PT

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	225100000X	Physical Therapist	3610	HI
2	225100000X	Physical Therapist	PT24163	CA

General Provider Information

NPI Number	:	1548377948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN JEAN SILAN PT

Provider Business Mailing Address
First Line	:	68-1873 PANIOLO PL
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5222
Country	:	US
Telephone Number	:	808-938-7084
Fax Number	:	808-731-6997

Provider Business Practice Location Address
First Line	:	68-1873 PANIOLO PL
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5222
Country	:	US
Telephone Number	:	808-289-0601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	07/01/2024

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Directions to “ CAROLYN JEAN SILAN PT” Practice Location

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