Organization
PEDIATRIC THERAPIES HAWAII
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY PETERSON DPT (CEO)
(808) 446-2032
Entity
Organization
Contact information
Practice address
335 HOOHANA ST STE F, KAHULUI, HI 96732-3527
(808) 446-2032
Mailing address
28 MANO DR, KULA, HI 96790-8526
(808) 446-2032
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT-3395
HI
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
835241
—
HI
Enumeration date
11/30/2017
Last updated
09/06/2022
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