Organization
WATERFRONT PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALYCE L KIM (MEMBER MANAGER)
(808) 593-4005
Entity
Organization
Contact information
Practice address
1221 KAPIOLANI BLVD, 6 G, HONOLULU, HI 96814
(808) 593-4005
(808) 591-2625
Mailing address
PO BOX 15683, HONOLULU, HI 96830-5683
(808) 593-4005
(808) 591-2625
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 1990
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000232694
HMSA
HI
Enumeration date
12/04/2006
Last updated
08/22/2020
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