Organization
MPT SOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA DAVIS (BILLER)
(808) 823-0103
Entity
Organization
Contact information
Practice address
320 WARD AVE STE 107, HONOLULU, HI 96814-4016
(808) 597-1005
Mailing address
320 WARD AVE STE 107, HONOLULU, HI 96814-4016
(808) 597-1005
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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