Organization
SOUTH SHORE PHYSICAL THERAPY & SPORTSMEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY GRACE PRANGNELL (PRESIDENT)
(808) 298-4933
Entity
Organization
Contact information
Practice address
118 MAA ST, KAHULUI, HI 96732-3602
(808) 244-0077
(808) 244-0177
Mailing address
118 MAA ST, KAHULUI, HI 96732-3602
(808) 244-0077
(808) 244-0177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/30/2025
Last updated
12/30/2025
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