Provider Demographics
NPI:1275395881
Name:KILAUEA PHYSICAL THERAPY LLP
Entity type:Organization
Organization Name:KILAUEA PHYSICAL THERAPY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:808-469-6906
Mailing Address - Street 1:2430B OKA ST
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-5332
Mailing Address - Country:US
Mailing Address - Phone:808-320-0370
Mailing Address - Fax:808-320-7014
Practice Address - Street 1:2430B OKA ST
Practice Address - Street 2:
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754-5332
Practice Address - Country:US
Practice Address - Phone:808-320-0370
Practice Address - Fax:808-320-7014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty