Individual
DEREK KETELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
800 S KING ST, HONOLULU, HI 96813-3010
(563) 212-0377
Mailing address
800 S KING ST, HONOLULU, HI 96813-3010
(808) 522-4603
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
4648
HI
Other
Enumeration date
06/26/2019
Last updated
05/08/2020
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