# MAUI MOBILE PHYSICAL THERAY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063921310
- **Authorized official:** ANDREW STAMP (MEMBER)
- **Authorized official phone:** (808) 463-9774

## Contact information

- **Practice address:** 1010 FRONT ST, LAHAINA, HI 96761-1673
- **Practice address phone:** (808) 463-9774
- **Practice address fax:** (888) 972-6936
- **Mailing address:** PO BOX 213, LAHAINA, HI 96767-0213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 2957 | HI | Yes |

## Other

- **Enumeration date:** 09/29/2017
- **Last updated:** 06/20/2018