# DNA ACTIVE REHAB AND PERFORMANCE, LLC

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

## Provider details

- **NPI number:** 1548695000
- **Authorized official:** KENNETH NAKASONE DPT, ATC (CO-OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (808) 375-0968

## Contact information

- **Practice address:** 771 AMANA ST \# 201, HONOLULU, HI 96814-3238
- **Practice address phone:** (808) 375-0968
- **Practice address fax:** (866) 446-2433
- **Mailing address:** 771 AMANA ST \# 201, HONOLULU, HI 96814-3238
- **Mailing address phone:** (808) 375-0968
- **Mailing address fax:** (866) 446-2433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT-2354 | HI | Yes |

## Other

- **Enumeration date:** 09/03/2013
- **Last updated:** 05/17/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1932269297 | NPI | HI |