Individual
MR. GLENN MASAO TAIRA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
94-1480 MOANIANI ST, WAIPAHU, HI 96797-4632
(808) 432-3186
(808) 432-3249
Mailing address
98-418 KAONOHI ST #1, AIEA, HI 96701
(808) 226-2969
(808) 432-3249
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1713
HI
Other
Enumeration date
05/23/2006
Last updated
07/08/2007
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