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Individual

MR. CODY VINCENT GILLISS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
3030 PUALEI CIR APT 210, HONOLULU, HI 96815-4942
(808) 892-8999
Mailing address
3030 PUALEI CIR APT 210, HONOLULU, HI 96815-4942
(808) 892-8999

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4614
HI

Other

Enumeration date
08/20/2017
Last updated
01/23/2023
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