Provider Demographics
NPI:1992995450
Name:TOMOMITSU, KERI FUSAE (PT)
Entity type:Individual
Prefix:MS
First Name:KERI
Middle Name:FUSAE
Last Name:TOMOMITSU
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 1:3221 WAIALAE AVE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5842
Mailing Address - Country:US
Mailing Address - Phone:808-734-0020
Mailing Address - Fax:808-732-0010
Practice Address - Street 1:3221 WAIALAE AVE
Practice Address - Street 2:SUITE 360
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5842
Practice Address - Country:US
Practice Address - Phone:808-734-0020
Practice Address - Fax:808-732-0010
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT - 2771225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist