Provider Demographics
NPI:1992150825
Name:LAULIMA PHYSICAL THERAPY & REHABILITATION LLC
Entity type:Organization
Organization Name:LAULIMA PHYSICAL THERAPY & REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-208-2371
Mailing Address - Street 1:458 MANAWAI ST
Mailing Address - Street 2:UNIT 1203
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707
Mailing Address - Country:US
Mailing Address - Phone:808-208-2371
Mailing Address - Fax:
Practice Address - Street 1:590 FARRINGTON HWY # 524-415
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2009
Practice Address - Country:US
Practice Address - Phone:808-208-2371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy