MEDICARE: MR. LAWRENCE NINO

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1982360996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAWRENCE NINO

Provider Business Mailing Address
First Line	:	1406 COLBURN ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96817-4903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1406 COLBURN ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96817-4903
Country	:	US
Telephone Number	:	808-843-8372
Fax Number	:

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

Provider Enumeration Date	:	11/14/2021
Last Update Date	:	11/14/2021

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Directions to “ MR. LAWRENCE NINO ” Practice Location

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