Organization
NINTH ISLAND PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB JAMES TATSUMI HAUGHT PT, DPT (MANAGING MEMBER)
(808) 343-8162
Entity
Organization
Contact information
Practice address
125 WESTIN LN, HENDERSON, NV 89002-5115
(808) 343-8162
Mailing address
125 WESTIN LN, HENDERSON, NV 89002-5115
(808) 343-8162
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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