Organization
PAKOLEA REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUNA RUSSELL DPT (OWNER)
(808) 553-5199
Entity
Organization
Contact information
Practice address
135 S WAKEA AVE, KAHULUI, HI 96732-1385
(808) 553-5199
Mailing address
135 S WAKEA AVE, KAHULUI, HI 96732-1385
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
AT-212
HI
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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