# WATERFRONT PHYSICAL THERAPY LLC

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

## Provider details

- **NPI number:** 1235297151
- **Authorized official:** MRS. ALYCE L KIM (MEMBER MANAGER)
- **Authorized official phone:** (808) 593-4005

## Contact information

- **Practice address:** 1221 KAPIOLANI BLVD, 6 G, HONOLULU, HI 96814
- **Practice address phone:** (808) 593-4005
- **Practice address fax:** (808) 591-2625
- **Mailing address:** PO BOX 15683, HONOLULU, HI 96830-5683
- **Mailing address phone:** (808) 593-4005
- **Mailing address fax:** (808) 591-2625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT 1990 | HI | Yes |

## Other

- **Enumeration date:** 12/04/2006
- **Last updated:** 08/22/2020