Organization
KIHEI-WAILEA PHYSICAL THERAPY INC.
Active
Other names
Back In Shape
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA E SANDERS PT (PRESIDENT)
(808) 879-5591
Entity
Organization
Contact information
Practice address
84 CENTRAL AVE, WAILUKU, HI 96793-1725
(808) 879-5591
Mailing address
PO BOX 508, KIHEI, HI 96753-0508
(808) 879-5591
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
561
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000231639
HMSA
HI
Enumeration date
04/13/2007
Last updated
08/22/2020
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