Organization
EWA BEACH PHYSICAL THERAPY LLC
Active
Parent organization
EWA BEACH PHYSICAL THERAPY LLC
Other names
Westside Physical Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
EWA BEACH PHYSICAL THERAPY LLC
Authorized official
MR. GRANT H TAKIGUCHI PT (OWNER)
(808) 689-9994
Entity
Organization
Contact information
Practice address
91-1121 KEAUNUI DR STE 203, EWA BEACH, HI 96706-6366
(808) 689-9994
(808) 689-9995
Mailing address
91-2139 FORT WEAVER RD STE 210, EWA BEACH, HI 96706-3609
(808) 689-9994
(808) 689-9995
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024988
HMSA
HI
05
—
768765
—
HI
Enumeration date
09/21/2022
Last updated
09/14/2023
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