# MPT SOUTH LLC

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

## Provider details

- **NPI number:** 1154997435
- **Authorized official:** JOANNA DAVIS (BILLER)
- **Authorized official phone:** (808) 823-0103

## Contact information

- **Practice address:** 320 WARD AVE STE 107, HONOLULU, HI 96814-4016
- **Practice address phone:** (808) 597-1005
- **Mailing address:** 320 WARD AVE STE 107, HONOLULU, HI 96814-4016
- **Mailing address phone:** (808) 597-1005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2021
- **Last updated:** 05/27/2021