Individual
AMANDA PROBERT ELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
2395 S KIHEI RD, STE. 206, KIHEI, HI 96753-8635
(808) 873-8478
(808) 874-0501
Mailing address
2395 S KIHEI RD, STE 206, KIHEI, HI 96753-8635
(808) 873-8478
(808) 874-0501
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1958
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1958
STATE LICENSE NUMBER
HI
Enumeration date
06/12/2006
Last updated
03/03/2017
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