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Individual

DR. JEFFREY BAUTISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1001 KAMOKILA BLVD STE 114, KAPOLEI, HI 96707-2095
(808) 674-0500
Mailing address
91-1075 KAUNOLU ST, EWA BEACH, HI 96706-2852
(808) 259-1740

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-5283
HI

Other

Enumeration date
10/04/2021
Last updated
10/04/2021
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