Organization
ACTIVE HAWAII PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAH NOTTINGHAM (CPO)
(415) 533-4863
Entity
Organization
Contact information
Practice address
78-6831 ALII DR STE 420, KAILUA KONA, HI 96740-5403
(808) 498-4144
(808) 498-4153
Mailing address
23 FERN AVE, MILL VALLEY, CA 94941-2824
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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