Provider Demographics
NPI:1720130099
Name:HESTER, DANA L (PT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:HESTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1545
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1545
Mailing Address - Country:US
Mailing Address - Phone:205-499-1167
Mailing Address - Fax:
Practice Address - Street 1:91-2139 FORT WEAVER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3607
Practice Address - Country:US
Practice Address - Phone:808-689-9994
Practice Address - Fax:808-689-9995
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008389225100000X
HIPT2816225100000X
HIPT-2816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA579848594AMedicaid